Hyperfunctioning Papillary Microcarcinoma Diagnosed by 124I PET/Ultrasound Fusion Imaging

A 49-year-old woman presented with a multinodular goiter, causing local symptoms and hyperthyroisdism. Besides a hypofunctioning benign nodule (TIRADS 3, benign in FNAC), the conventional diagnostic revealed another small hyperfunctioning nodule with suspicious ultrasound features (TIRADS 4C). To rule out a trapping-only nodule and topographical misalignments, a 124I PET/ultrasound fusion was performed and confirmed elevated iodine uptake within the suspicious nodule. Further disseminated autonomous areas are suspected to be additionally responsible for the low TSH-level. Because of the local cervical symptoms and the hyperthyroidism, the patient underwent surgery. The small hyperfunctioning nodule turned out to be a classic papillary microcarcinoma. Received for publication October 18, 2018; revision accepted January 10, 2019. Conflicts of interest and sources of funding: none declared. Correspondence to: Martin Freesmeyer, MD, Clinic of Nuclear Medicine, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany. E-mail: martin.freesmeyer@med.uni-jena.de. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

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