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Incidental Primary Intrathoracic Goiter: Dual-Isotope Scintigraphy and Early-MIBI SPECT/CT.

E Zamora1, S Ghandili1, M A Zamora2

  • 1Department of Radiology, Division of Nuclear Medicine, Montefiore Medical Center and the Albert Einstein College of Medicine, Bronx, New York, United States.

World Journal of Nuclear Medicine
|July 22, 2022
PubMed
Summary

Primary intrathoracic goiter, a rare congenital condition, was incidentally discovered using technetium-99m sestamibi SPECT/CT. This imaging technique proved effective for identifying ectopic thyroid tissue, even when standard scintigraphy was inconclusive.

Keywords:
MIBISPECT/CThyperparathyroidismprimary intrathoracic goiterscintigraphy

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Area of Science:

  • Nuclear Medicine
  • Radiology
  • Endocrinology

Background:

  • Primary intrathoracic goiter is a rare congenital anomaly arising from ectopic thyroid tissue, distinct from orthotopic thyroid.
  • These goiters can cause serious complications, including malignancy and dyspnea.
  • Conventional scintigraphy with 99m Tc-pertechnetate often shows minimal or absent uptake in these lesions.

Observation:

  • A case of incidental primary intrathoracic goiter is presented.
  • The patient was undergoing evaluation for parathyroid adenomas using multimodal scintigraphy.
  • Early 99m Tc-sestamibi single-photon emission computed tomography/computed tomography (SPECT/CT) was employed.

Findings:

  • The intrathoracic goiter was inconspicuous on 99m Tc-pertechnetate scintigraphy.
  • However, the lesion demonstrated avid uptake of 99m Tc-sestamibi on early planar and SPECT/CT imaging.
  • This highlights the utility of 99m Tc-sestamibi SPECT/CT in detecting ectopic thyroid tissue.

Implications:

  • 99m Tc-sestamibi SPECT/CT can be a valuable tool for diagnosing primary intrathoracic goiter, especially when other methods are equivocal.
  • Early detection and characterization of ectopic thyroid tissue are crucial for managing potential complications.
  • This case expands the diagnostic applications of 99m Tc-sestamibi SPECT/CT in nuclear medicine.