Toxic thyroid adenoma (thyroid scintigraphy)

Case contributed by Arshdeep Sidhu

Presentation

Fatigue and weight loss.

Patient Data

Age: 60 years
Gender: Female

Thyroid Scintigraphy

Nuclear medicine

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.

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