Medullary Thyroid Carcinoma with Micronodular Lung Metastases: A Case Report with an Emphasis on the Imaging Findings

Abstract

Medullary thyroid carcinoma is a rare malignancy that arises from calcitonin-producing C-cells and frequently metastasizes to lymph nodes in the neck. Distant metastases may involve bone, lung, and liver. The infrequent number of cases limits the clinical nature and ability to optimize diagnostic tools. Here, we present a case of a micronodular radiographic pattern in metastatic medullary thyroid cancer in order to enhance awareness of the disease process. A case discussion and relevant review of the literature are provided.

State of the art and future directions in the systemic treatment of medullary thyroid cancer

“…transarterial embolization can be used for liver metastases [37][38][39]. Lung metastases are often multiple and combined with mediastinal lymph node metastases [14,[40][41][42]. EBRT, surgery or stenting may be considered in case of bleeding or compression of the airways [43][44][45].…”

Medullary Thyroid Carcinoma: An Update on Imaging

“…Pulmonary metastases in MTC may exhibit a micronodular pattern or have a large, well-circumscribed, round macronodular appearance, also known as a “cannonball” pattern. Micronodular metastases have a nonspecific appearance, which may calcify and can be easily mistaken for granulomatous diseases, such as tuberculosis, histoplasmosis, or sarcoidosis [64, 65]. A lymphangitic spread of the tumor with amyloid deposition in peribronchovascular structures without alveolar involvement resulting in reticulonodular perihilar opacity on imaging was also reported [66].…”