[Diagnosis of achalasia using 99m-Tc pertechnetate scintigraphy]

A 73-year-old patient presented a 99mTc scintiscan with a focal tracer accumulation left and caudal of the thyroid gland. Further investigations with sonography, CT, esophagoscopy and barium swallow provided the diagnosis of achalasia as the reason for focal 99mTc retention caudal of the thyroid gland. Explanation for 99mTc accumulation within the esophagus may be the nonspecific accumulation of 99mTc not only in the thyroid gland but also in the salivary glands. Excretion of the tracer follows with the saliva. Structural and motor disorders of the esophagus can thus lead to focal tracer retention within the esophagus simulating thyroid tissue.