Palpation Thyroiditis Seen on F-18 FDG PET/CT

Abstract

A 29-year-old woman presented with a new right supraclavicular mass on a background of resection of a malignant melanoma from her right shoulder before 4 years. F-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) imaging revealed uptake in a right supraclavicular node and the inferior pole of the left lobe of the thyroid gland. Subsequent resection and histology of the right supraclavicular node and the left lobe of the thyroid gland demonstrated metastatic melanoma and palpation thyroiditis, respectively. A number of malignant and benign pathologies of the thyroid demonstrate FDG uptake, with 75% being benign. To our knowledge, the findings of palpation thyroiditis on FDG PET/CT have never been previously described.

2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis

“…They named this pathologic entity ''palpation thyroiditis,'' concluding that it was due to palpation of the thyroid gland at surgery. It was generally thought to be of little clinical importance, except for rare case reports of patients who developed thyrotoxicosis following manipulation of the thyroid gland during surgery (633)(634)(635)(636). However, a recent study suggested that the rate of transient overt or subclinical thyrotoxicosis following parathyroid surgery may be as high as 30%, although there was likely ascertainment bias because not all patients had postoperative TSH levels measured (637).…”