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Incidental Warthin Tumor on Pertechnetate Scintigraphy.

Mukta Kulkarni¹, Shubhangi Shetkar, Prathamesh Joshi

¹From the *Samarth Clinic, Aurangabad; and Departments of †Radiology, and ‡Nuclear Medicine, Tapadia Diagnostic Centre, Aurangabad, India.

Clinical Nuclear Medicine

|July 13, 2016

Summary

Thyroid scintigraphy for thyrotoxicosis incidentally revealed a parotid gland lesion. Technetium-99m pertechnetate uptake suggested Warthin tumor, later confirmed by surgery.

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Area of Science:

Nuclear medicine
Oncology
Endocrinology

Background:

Thyroid scintigraphy using Tc-99m pertechnetate is a standard diagnostic tool for thyrotoxicosis.
Graves disease is a common cause of hyperthyroidism, characterized by a diffusely hypervascular thyroid gland.
Warthin tumor is a benign salivary gland neoplasm, typically found in the parotid gland.

Observation:

A 30-year-old woman presented for evaluation of thyrotoxicosis.
Tc-99m pertechnetate scintigraphy showed a hypervascular thyroid gland consistent with Graves disease.
An incidental hypervascular, pertechnetate-avid focus was noted in the right parotid gland.

Findings:

The parotid gland uptake suggested a Warthin tumor.
Clinical examination and ultrasound revealed a well-defined lesion in the superficial lobe of the right parotid gland.
Post-surgical histopathology confirmed the diagnosis of Warthin tumor.

Implications:

This case highlights the potential for incidental findings on thyroid scintigraphy.
Tc-99m pertechnetate uptake can aid in the diagnosis of Warthin tumor.
Multimodality imaging and histopathology are crucial for accurate diagnosis of salivary gland lesions.