Korean J Radiol.  2009 Apr;10(2):101-105. 10.3348/kjr.2009.10.2.101.

Ultrasonographic Findings of Medullary Thyroid Carcinoma: a Comparison with Papillary Thyroid Carcinoma

• Kim SH
• Kim BS
• Jung SL
• Lee JW
• Yang PS
• Kang BJ
• Lim HW
• Kim JY
• Whang IY
• Kwon HS
• Jung CK

• KMID: 1088719
• DOI: http://doi.org/10.3348/kjr.2009.10.2.101

Abstract

OBJECTIVE
This study was designed to evaluate the ultrasonographic (US) findings of medullary thyroid carcinoma (MTC) as compared to findings for papillary thyroid carcinoma (PTC).
MATERIALS AND METHODS
The study included 21 cases of MTC that were surgically diagnosed between 2002 and 2007 and 114 cases of PTC that were diagnosed in 2007. Two radiologists reached a consensus in the evaluation of the US findings. The US findings were classified as recommended by the Thyroid Study Group of the Korean Society of Neuroradiology and Head and Neck Radiology (KSNHNR) and each nodule was identified as suspicious malignant, indeterminate or probably benign. The findings of medullary and papillary carcinomas were compared with use of the chi-squared test.
RESULTS
The common US findings for MTCs were solid internal content (91%), an ovoid to round shape (57%), marked hypoechogenicity (52%) and calcifications (52%). Among the 21 cases of MTC nodules, 17 (81%) were classified as suspicious malignant nodules. The mean size (longest diameter) of MTC nodules was 19 +/- 13.9 mm and the mean size (longest diameter) of PTC nodules was 11 +/- 7.4 mm; this difference was statistically significant (p < 0.05). An ovoid to round shape was more prevalent for MTC lesions than for PTC lesions (p < 0.05).
CONCLUSION
The US criteria for suspicious malignant nodules as recommended by the Thyroid Study Group of the KSNHNR correspond to most MTC cases. The US findings for MTC are not greatly different from PTC except for the prevalence of an ovoid to round shape.

Keyword

Thyroid; Thyroid, neoplasms; Thyroid, US

MeSH Terms

Adult
Aged
Calcitonin/blood
Carcinoma, Medullary/*ultrasonography
Carcinoma, Papillary/*ultrasonography
Case-Control Studies
Female
Humans
Male
Middle Aged
Thyroid Neoplasms/*ultrasonography

Figure

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  Fig. 1 Ultrasonography performed on 55-year-old female with medullary thyroid carcinoma. Sagittal scan shows 13 mm, solid, ovoid to round, markedly hypoechoic nodule with spiculated border (arrows) and internal macrocalcifications. This nodule was classified as suspicious malignant.

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  Fig. 2 Ultrasonography performed on 61-year-old female with medullary thyroid carcinoma. Transverse scan shows 18 mm, solid, ovoid to round, hypoechoic nodule with smooth border. This nodule was classified as indeterminate.

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  Fig. 3 Ultrasonography performed on 51-year-old male with papillary thyroid carcinoma. Transverse scan shows 6 mm, solid, taller than wide, hypoechoic nodule (arrow) with spiculated border and internal microcalcifications. This lesion was classified as suspicious malignant nodule.

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