Table 3 Surgical treatment and outcome of patients with FDG-PET-avid recurrent papillary thyroid cancer

1

Neck lesions, levels 2 and 3

Palpable mass, level 2/3

Dissection upper neck, left side

Persistent disease;

FNA: metastatic PTC

Tg 56.5 μg/L,

no more PET-positive lesions;

ultrasound:

multiple small nodes <1 cm

2

Two neck lesions, right side; jugular node

Palpable lymph node, right side of the neck

Right-sided neck dissection

Loco-regional control without evidence of residual disease after surgical resection of both lesions;

Tg 33.5

low Tg levels (3.8 μg/L);

ultrasound without evidence of suspicious lymph nodes in the neck;

negative PET scan and a negative whole-body iodine scan after four years of follow-up

3

Neck lesion

Lesion detected on ultrasound: size 1.2 cm

Lymph node resection in the central neck

Progressive disease

FNA: recurrent tumor

PET-positive lesions in the neck and lungs

4

Neck lesion

Palpable lesion near right clavicle.

Right neck dissection

Died

Tg level was 63.8 μg/L.

5

Neck and lung metastases

Lesion detected on ultrasound: size 1 cm.

Central neck dissection

Progressive disease

Tg level was 8.6 μg/L

Tg level increased from 7.9 to 17 μg/L

PET scan showed lung metastasis but no residual disease in the neck

6

Neck lesion; PET scan initially interpreted as negative, but later interpreted as positive

Palpable mass of 2.3 cm near the left mandible, also shown by ultrasound

Several small nodes were resected and the large node

Persistent disease

FNA: recurrent tumor

7

Solitary mediastinal lesion

Lesion also seen on MRI, size: 1.8 x 1.3 cm

Mediastinal lymph node dissection, followed by radioactive iodine

Loco-regional control without evidence of residual disease: Tg level decreased to 0.2 μg/L up until seven years of follow-up;

Tg level was 12 μg/L

ultrasound showed no residual disease in neck;

No ultrasound

CT scan two years after treatment showed no evidence of pulmonary metastasis