Thyroid carcinoma m solitary hot thyroid lesions on Tc-99m sodium pertechnetate scans

Abstract

Sixteen patients with nonsuppressible solitary hot thyroid lesions (SHTL) identified on T3 suppression images using Tc-99m sodium pertechnetate were studied over a period of 5 years. Of the 16 patients, 7 (44%) had papillary adenocarcinoma (PAC) and 9 (56%) had follicular adenoma (FA). Of the 7 patients with PAC, 3 were toxic and 4 nontoxic. Of the 9 patients with FA, 2 were toxic and 7 nontoxic. The Tl-201 chloride thyroid scans were useful in locating SHTL and revealing extranodular thyroid tissue. The echography was sensitive to visualization of the nodule structures. However, there were no significant differences between the clinical findings, radionuclide images, and echograms between for PAC and FA. All patients with PAC were treated by partial thyroidectomy and there were neither regional nor distant metastasis in any of them. In conclusion, our study provided the following extremely interesting result: SHTL in the present series have a higher incidence of malignancy than previously reported autonomously functioning thyroid lesions (AFTL). Histological examination is necessary for the diagnosis and management of SHTL and surgical treatment should be considered.

Clinico-pathological Features of Thyroid Cancer as Observed in Five Referral Hospitals in Iran

“…Usually, with decreasing differentiation of thyroid neoplasm, their ability to trap and organify iodide declines; however, a hyperfunctioning nodule may rarely be malignant (30).…”

Mortality from thyroid cancer in patients with hyperthyroidism: the Theagenion Cancer Hospital experience

“…In 58.8% of solitary autonomous adenomas associated with thyroid cancer, the tumor was located within the hot area observed on the isotope scan, including the two autonomous solitary adenomas that led to death. Thyroid cancer (either papillary or follicular) has been described in association with autonomously functioning adenomas (32,33). Whether the two neoplasms (papillary thyroid cancer and follicular adenoma) arise independently of each other, or their coincidence is linked, is unknown.…”

Thyroid Carcinoma in Hot Nodules: Review of the Literature

“…Out of these 31 articles, 16 articles (five series of cases and 11 case reports) included cases matching the previously mentioned criteria for a total of 45 reported cases. 6,7,[11][12][13][14][15][16][17][18][19][20][21][22][23][24] Among these 45 cases, the histological repartition was as follow: 25 (56%) follicular carcinoma, 16 (36%) papillary carcinoma including at least four (9%) confirmed follicular variant, two (4%) Hürthle cells thyroid cancer, one (2%) poorly differentiated thyroid cancer and we were not able to find the histology for one case (Table 1).…”