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An autonomous functioning cystic thyroid adenoma. An unusual occurrence.
Clinical Nuclear Medicine
|December 1, 1986
Summary
A rare case of a cystic thyroid nodule in a teenage girl was found to be hyperfunctioning, not cold as expected. Surgical removal revealed a hemorrhagic cystic adenoma, an unusual finding for a cystic nodule.
Area of Science:
- Endocrinology
- Nuclear Medicine
- Surgical Pathology
Background:
- Thyroid nodules are common, but cystic presentations are less frequent.
- Hyperfunctioning thyroid nodules typically appear solid on imaging.
- Cystic nodules are often presumed to be non-functional or 'cold' on thyroid scans.
Observation:
- A 14-year-old female presented with an asymptomatic thyroid nodule.
- Initial ultrasound suggested a cystic nodule.
- Technetium-99m pertechnetate scintigraphy unexpectedly revealed a hyperfunctioning nodule.
Findings:
- Surgical pathology confirmed the nodule as a hemorrhagic cystic adenoma.
- The cystic adenoma demonstrated significant thyroid hormone production, indicated by hyperfunction on imaging.
- This represents an unusual combination of cystic morphology and hyperfunction.
Implications:
- Challenges the typical assumption that cystic thyroid nodules are non-functional.
- Highlights the importance of functional imaging in evaluating cystic thyroid lesions.
- Suggests that hemorrhagic cystic adenomas can present as hyperfunctioning nodules, requiring careful diagnostic consideration.