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Related Concept Videos

Synthesis and Regulation of Thyroid Hormones01:20

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Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
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Updated: May 10, 2025

Substernal Thyroid Biopsy Using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration
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SSTR Expressing Mediastinal Ectopic Thyroid: A Rarity Unveiled.

Yogita Khandelwal1, Nishikant Avinash Damle1, Mohit Kumar Joshi2

  • 1Department of Nuclear Medicine, AIIMS, New Delhi, India.

Indian Journal of Nuclear Medicine : IJNM : the Official Journal of the Society of Nuclear Medicine, India
|April 28, 2025
PubMed
Summary

Ectopic mediastinal thyroid tissue, rarely seen with normal thyroids, can show unusual imaging findings. This case highlights increased Gallium-68 DOTANOC uptake in ectopic thyroid tissue, despite absent technetium pertechnetate uptake.

Keywords:
68Ga-DOTANOC positron emission tomography–computed tomography99mTechnetium-pertechnetate scanectopic mediastinal thyroid

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Area of Science:

  • Nuclear medicine
  • Endocrinology
  • Radiology

Background:

  • Ectopic thyroid tissue, while uncommon, can occur alongside a normally located thyroid gland.
  • Technetium pertechnetate scintigraphy is the standard imaging modality for assessing thyroid tissue, including ectopic locations.
  • Gallium-68 DOTANOC positron emission tomography-computed tomography (PET-CT) uptake in mediastinal ectopic thyroid tissue is rarely documented.

Purpose of the Study:

  • To report a unique case of ectopic mediastinal thyroid tissue with atypical imaging characteristics.
  • To investigate the utility of Gallium-68 DOTANOC PET-CT in evaluating ectopic thyroid tissue that does not concentrate technetium pertechnetate.

Main Methods:

  • Case presentation of a patient with an ectopic mediastinal thyroid mass.
  • Comparison of imaging findings between technetium pertechnetate scintigraphy and 68Ga-DOTANOC PET-CT.
  • Correlation with the presence of eutopic cervical thyroid tissue.

Main Results:

  • The ectopic mediastinal thyroid mass demonstrated no uptake on technetium pertechnetate scan.
  • Significantly increased uptake was observed on 68Ga-DOTANOC PET-CT in the ectopic mediastinal thyroid mass.
  • The eutopic cervical thyroid showed normal technetium pertechnetate uptake and physiological mild DOTANOC uptake.

Conclusions:

  • Ectopic mediastinal thyroid tissue can exhibit variable uptake patterns on nuclear imaging.
  • 68Ga-DOTANOC PET-CT may be a valuable tool for detecting and characterizing ectopic thyroid tissue, especially when conventional scans are negative.
  • This case expands the understanding of imaging modalities for ectopic thyroid tissue.