PurposeThe BRAFV600E mutation represents a novel indicator of the progression and aggressiveness of papillary thyroid carcinoma (PTC). The purpose of this study was to determine the clinical significance of free circulating mutant BRAFV600E in predicting the advanced disease of PTC.Materials and MethodsSeventy seven matched tumor and plasma samples obtained from patients with both benign and PTC were analyzed for BRAFV600E mutation using a peptide nucleic acid (PNA) clamp real-time polymerase chain reaction (PCR).ResultsThe BRAFV600E mutation was absent in tumor DNA samples obtained from patients with benign follicular adenomas or adenomatous goiter. In contrast, 49 of 72 (68.1%) PTC tumors were positive for the BRAFV600E mutation. Among them, 3 (6.1%) patients with PTC were positive for BRAFV600E mutation in plasma and tumor. However, all 3 patients (100%) had lateral lymph node and lung metastasis.ConclusionThese findings suggest that the BRAFV600E mutation can be detected using a PNA clamp real-time PCR in the blood of PTC patients with lung metastasis. Future studies are warranted to determine clinical significance of serum BRAFV600E mutation in large prospective studies.

The MTV measured by FDG-PET was an independent prognostic factor for tumor recurrence in patients with stage IA-IIB cervical cancer. These findings must be confirmed by large population based prospective studies.

Key Points Question Is radioactive iodine (RAI) therapy for hyperthyroidism associated with an increased cancer risk? Findings This systematic review and meta-analysis, including 12 observational studies and 479 452 participants, found that RAI therapy was not associated with a significant increase in overall cancer risk or site-specific cancer incidence or mortality, except for thyroid cancer. However, a linear radiation dose-response association between RAI therapy and solid cancer mortality was observed, based on 2 studies with information on RAI administered dose. Meaning Considering the global use of RAI therapy for hyperthyroidism, further studies are needed to provide quantitative estimates of site-specific cancer risks associated with RAI therapy, particularly at higher doses.

We report a rare case of distant subcutaneous parathyroid carcinoma recurrence. A 50-year-old woman was referred to our hospital because of sustained hypercalcemia despite surgical removal of a parathyroid carcinoma. A focal uptake in the upper mediastinal area was detected in a 99mTc-sestamibi scan, and 18F-fluorodeoxyglucose (FDG) positron-emission tomography (PET)/computed tomography (CT) imaging demonstrated a subcutaneous mass. She underwent tumor resection, and the pathological findings were consistent with a parathyroid carcinoma. The postoperative serum parathyroid hormone (PTH) level remained within normal limits. However, a new palpable solitary mass was identified in the upper portion of the left breast 1 year postoperatively. Both a 99mTc-sestamibi scan and 18F-FDG PET/CT imaging revealed an abnormal lesion in the upper breast, and subsequent pathology reports confirmed parathyroid carcinoma metastasis. Serum PTH and calcium levels fell within normal ranges after tumor resection. Two subcutaneous recurrent lesions appeared likely due to tumor seeding during the previous endoscopic operation at a local hospital.

BackgroundThere has been much controversy over specific tests for diagnosis of supraspinatus tendon tear. The aim of this study was to evaluate the metabolic activity of the deltoid and rotator cuff muscles while maintaining the full-can and empty-can testing positions using 2-deoxy-2-[18 F]fluoro-D-glucose (18 F-FDG) positron emission tomography (PET)/computed tomography (CT).MethodsTen healthy volunteers without shoulder pain or diabetes mellitus participated in this study. Following FDG injection, both arms were maintained in either the empty-can or full-can position for 10 min. PET/CT was performed 40 min after injection. Maximum standardized uptake values (SUVs) were measured in the deltoid and rotator cuff muscles on axial PET images.ResultsThe middle deltoid exhibited the most significant increase in muscle activity at both testing positions. Additionally, a significant increase in muscle activity was observed in the middle deltoid compared with the supraspinatus (P < 0.05) in the empty-can testing position. SUVs of the middle deltoid, supraspinatus, and subscapularis showed a significant increase in the empty-can testing position compared with the full-can testing position (P < 0.05).ConclusionsSignificantly increased activity of the supraspinatus in conjunction with the middle deltoid and subscapularis after empty-can testing may result in decreased specificity of the empty-can test in detecting isolated supraspinatus activity. The full-can test, however, may be used to test the function of the supraspinatus with the least amount of surrounding middle deltoid and subscapularis activity.