Presentation
Fatigue and weight loss.
Patient Data
Anterior images show elevated Tc99m-pertechnetate uptake in a specific focal area of the left thyroid lobe (red arrow) relative to the extra-nodular thyroid tissue (yellow arrow), which demonstrates decreased (partial suppression) or absent (complete suppression) uptake due to decreased TSH levels. Salivary gland (arrowhead) is barely visualized secondary to decreased background activity.
Case Discussion
A hot (hyperfunctioning) nodule on thyroid scintigraphy is a characteristic finding in toxic thyroid adenoma. Not all nodules are toxic, and some cases may present as euthyroid. Radiotracer uptake is focal, unlike in Graves disease.