case_images: PMC6076977_01
case_images: Surgical pathology of the right clavicular mass revealing metastatic papillary adenocarcinoma.
case_images: CRIE2018-8956712.001.jpg
case_images: PMC6076977_01_CRIE2018-8956712.001.jpg
case_images: fig1
case_images: A fine needle aspiration of the mass was performed; histology showed papillary thyroid carcinoma [Figure 1].
case_images: Coronal-fused 18F-FDG PET/CT shows FDG avid lesion in the distal right clavicle with osseous destruction and an FDG avid mediastinal mass displacing the trachea to the left.
case_images: CRIE2018-8956712.002.jpg
case_images: PMC6076977_01_CRIE2018-8956712.002.jpg
case_images: fig2
case_images: The thyroid gland was small and atrophic [Figure 2].
case_images: Axial chest CT showing a hypodense, solid, infrahyoid mass extending to the superior mediastinum.
case_images: CRIE2018-8956712.003.jpg
case_images: PMC6076977_01_CRIE2018-8956712.003.jpg
case_images: fig3
case_images: Postsurgery CT scan showed a hypodense, solid, infrahyoid mass extending to the superior mediastinum with surrounding adenopathy [Figure 3].
case_images: Pathology report of central neck biopsy of superior mediastinal mass revealing papillary thyroid carcinoma.
case_images: CRIE2018-8956712.004.jpg
case_images: PMC6076977_01_CRIE2018-8956712.004.jpg
case_images: fig4
case_images: The biopsy reported papillary carcinoma, with similar cellular characteristics as that reported in the clavicular mass; surgical pathology report revealed papillary thyroid carcinoma with tumor cells positive for TTF-1 and focally positive for thyroglobulin [Figure 4].
case_images: Left: posttherapy 131-iodine WBS shows no evidence of functional thyroid tissue. Right: coronal-fused images of 18F-FDG PET/CT study performed after posttherapy WBS show the FDG avid mediastinal and right shoulder masses.
case_images: CRIE2018-8956712.005.jpg
case_images: PMC6076977_01_CRIE2018-8956712.005.jpg
case_images: fig5
case_images: Follow-up PET/CT performed with 15 mCi [555 MBq] of 18F-FDG showed the previously described mediastinal FDG avid mass, with a cystic or necrotic area, development of hypermetabolic neck lymph nodes, axillary nodes, and pulmonary nodes and a large mass in the right shoulder area [SUV max: 5.5] [Figure 5].