Association of hyperfunctioning thyroid adenoma with thyroid cancer presenting as "trapping only" nodule at 99mTcO4- scintigraphy.
Rarely may a non-hyperfunctioning thyroid nodule present as "hot" at Technetium-99m pertechnetate (99mTcO4-) and "cold" at radioiodine scintigraphy at late acquisitions. We report the case of a hyperthyroid female patient whose 99mTcO4- scintigraphy showed two "hot" nodules, whereas Iodide-131 (131I-) revealed a lack of indicator uptake by the larger, and intense uptake by the smaller nodule. The patient underwent surgery: histology demonstrated that the larger nodule, mismatched at pertechnetate vs iodine scintigraphy, was a papillary carcinoma. Our suggestion is to perform thyroid scintigraphy with radioiodine in hyperthyroid patients with more than one nodule concentrating pertechnetate, especially when an ultrasonographic pattern possibly suspect for malignancy is present.
Radiology Unit Viterbo-Di Carlo, Castellana Grotte, Bari, Italy. allerlab@unige.it
L
L
dell'Erba
P
P
Gerundini
M
M
Caputo
M
M
Bagnasco
D002291:Carcinoma, Papillary / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D006980:Hyperthyroidism / Q000000981:diagnostic imaging*; D007457:Iodine Radioisotopes; D008875:Middle Aged; D011877:Radionuclide Imaging; D013670:Sodium Pertechnetate Tc 99m; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging*; D016606:Thyroid Nodule / Q000000981:diagnostic imaging*; D013965:Thyroidectomy
D007457:Iodine Radioisotopes; D013670:Sodium Pertechnetate Tc 99m