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Thyroid carcinoma masquerading as a solitary benign hyperfunctioning nodule.

M P Sandler1, B Fellmeth, K E Salhany

  • 1Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee 37232.

Clinical Nuclear Medicine
|June 1, 1988
PubMed
Summary
This summary is machine-generated.

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Solitary hot thyroid nodules are rarely malignant. This case reveals a 3-cm papillary carcinoma mimicking a benign lesion on Tc-99m and I-123 imaging, challenging current diagnostic criteria for hot nodules.

Area of Science:

  • Nuclear medicine
  • Endocrinology
  • Oncology

Background:

  • Focal hot nodules on iodine thyroid scans typically indicate benignancy with a very low malignancy risk.
  • Previous reports of hot carcinomas often involved small cancers adjacent to benign hot nodules.

Observation:

  • A 3-cm papillary thyroid carcinoma presented with imaging characteristics indistinguishable from a benign hot nodule on both Technetium-99m (Tc-99m) and Iodine-123 (I-123) scans.
  • Detailed scintigraphic-pathologic correlation confirmed the carcinoma was intrinsically part of the "hot" lesion, not incidentally coexisting.

Findings:

  • This case represents a rare instance of a malignant papillary thyroid carcinoma fulfilling all imaging criteria for a benign "hot" nodule.
  • The tumor's size and "hot" nature on radioiodine imaging mimicked a non-neoplastic process.

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Implications:

  • The findings necessitate a re-evaluation of the diagnostic approach to solitary hot thyroid nodules.
  • Management strategies for "hot" nodules may need adjustment to account for rare malignant presentations.
  • Further research is warranted to identify imaging or clinical features that might differentiate these rare malignant hot nodules.