Petal-Like Calcifications in Thyroid Nodules on Ultrasonography: A Rare Morphologic Characteristic of Calcification Associated With Aggressive Biological Behavior

Abstract

This study investigated a rare ultrasonographically detected thyroid petal-like calcification and its relationship with thyroid carcinoma and biological behavior. We described the clinical and ultrasonographical features of thyroid nodules with petal-like calcifications in 18 patients undergoing thyroid surgery and cervical lymph node dissection. All of the thyroid nodules with petal-like calcifications were papillary thyroid carcinomas (PTCs). Of the 18 patients, 13 (72.2%) had cervical central lymph node metastasis, and five (27.8%) had cervical lateral lymph node metastasis. Petal-like calcifications occurred in malignant thyroid nodules with a high incidence of lymph node metastasis, which may be a specific ultrasonographic feature associated with the aggressive biological behavior of PTC.

Keywords: contrast-enhanced ultrasound; conventional ultrasound; lymph node metastasis; papillary thyroid carcinoma; petal-like calcifications.