case_images: PMC11779720_01
case_images: Parathyroid carcinoma (H&E, x 400) from large cells with moderate nuclei polymorphism forming a solid-alveolar structure with thickened stroma, vascular (A, B) and fatty tissue invasion, atypical mitoses (C), and foci of necrosis (D); lymph nodes without signs of metastasis are shown.
case_images: fonc-14-1441083-g001.jpg
case_images: PMC11779720_01_fonc-14-1441083-g001.jpg
case_images: f1
case_images: IHC examination: (A) diffuse expression of PTH; (B) Ki-67 1.5%; (C) negative expression of PD-L1 with positive control (placenta); (D) positive VEGF expression.
case_images: fonc-14-1441083-g002.jpg
case_images: PMC11779720_01_fonc-14-1441083-g002.jpg
case_images: f2
case_images: There was no PD-L1 expression ( Figure 2C ), but diffuse positive expression of VEGF was observed ( Figure 2D ).
case_images: MSCT: native (A) and arterial (B) phases of contrast enhancement. A lesion with an oval shape, smooth clear contours, 6 mm x 5 mm x 5 mm in diameter (native density: 83 HU, 104 HU in the arterial phase and 93 HU in the venous phase) is detected paratracheal to the left ( ) along the lower contour of the left lobe of the thyroid gland. PET/CT with 11C-choline. The CT thorax (C, D) visualizes secondary lesions (mts) ( ) in S9 of the right and left lungs (C, D) and in S6 of the left lung (E, F), with hyperfixation ( ) of the radiopharmaceutical on PET.
case_images: fonc-14-1441083-g003.jpg
case_images: PMC11779720_01_fonc-14-1441083-g003.jpg
case_images: f3
case_images: US showed a hypoechogenic zone measuring 0.3 cm x 0.3 cm x 0.3 cm (EU-TIRADS 5) in the left thyroid lobe and a hypoechogenic nodule measuring 0.6 cmx 0.5 cm x 0.5 cm behind the left thyroid lobe, which correlated with the results of scintigraphy and CT ( Figures 3A, B ). The sontrast-enhanced CT also showed multiple metastases up to 16 mm in diameter in both lungs ( Figures 3C, E ), which were confirmed by PET-CT with 11C-choline in September 2023 (in S9 of the right lung, 16 mm x 17 mm, SUVmax = 2.96; in S6 of the left lung, up to 11 mm x 10 mm, SUVmax = 1.93) ( Figures 3D, F ).