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Intrathoracic toxic thyroid nodule causing hyperthyroidism with a multinodular normal functional cervical thyroid

Burcu Dirlik Serim1, Ulku Korkmaz2, Unal Can3

  • 1Department of Nuclear Medicine, Cardiology Institute, Istanbul University, Istanbul, Turkey.

Indian Journal of Nuclear Medicine : IJNM : the Official Journal of the Society of Nuclear Medicine, India
|July 8, 2016
PubMed
Summary

Radionuclide scintigraphy effectively detects intrathoracic goiter, even when it causes hyperthyroidism with a normal cervical thyroid. This imaging technique is crucial for diagnosing ectopic thyroid tissue in the mediastinum.

Keywords:
HyperthyroidismI-131Tc-99m pertechnetateintrathoracic goitertoxic nodule

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Area of Science:

  • Nuclear Medicine
  • Endocrinology
  • Radiology

Background:

  • Intrathoracic goiters are mediastinal masses originating from thyroid tissue.
  • They are typically secondary, extending from the cervical thyroid, or primary, arising from ectopic thyroid tissue.
  • Most intrathoracic goiters are nontoxic and cause mass effect rather than hyperthyroidism.

Observation:

  • This case report focuses on an intrathoracic goiter presenting with hyperthyroidism.
  • The cervical thyroid gland was noted to be functioning normally.
  • Radionuclide scintigraphy using Iodine-131 (I-131) and Technetium-99m pertechnetate ((99m)TcO4) was employed for diagnosis.

Findings:

  • Scintigraphy successfully identified the intrathoracic goiter.
  • The imaging demonstrated the ectopic thyroid tissue's function and location.
  • The study highlights the utility of I-131 and (99m)TcO4 scintigraphy in diagnosing functional intrathoracic goiters.

Implications:

  • Radionuclide scintigraphy is valuable for diagnosing rare cases of hyperthyroid-inducing intrathoracic goiters.
  • It aids in differentiating primary from secondary intrathoracic goiters.
  • Accurate diagnosis through scintigraphy is essential for appropriate patient management.