Q:

Is there any role of thyroid scintigraphy in this patient?

waelhammad
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2022-11-18
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• A 42-year-old male with no active medical problem noticed a thyroid nodule 1 year back and was told by ENT specialist not to worry about it. Now he has come as he feels that the nodule is becoming more prominent. 

• Physical examination: 1 × 2 cm right lower pole nodule. There is also a lymph node which is hard and about 2 cm in size in the upper cervical chain in the right lateral neck region. An ultrasound is done which shows features of multinodular goiter. The FNA is done from the lymph node which showed metastatic papillary thyroid cancer. The patient was subjected to total thyroidectomy with radical neck dissection.

Is there any role of thyroid scintigraphy in this patient?

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waelhammad
2022-11-18
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Serum TSH should be measured during the initial evaluation of a patient with a thyroid nodule. If the serum TSH is subnormal, a radionuclide (preferably 123I) thyroid scan should be performed. If the serum TSH is normal or elevated, then a radionuclide scan should not be performed as the initial imaging evaluation. Radionuclide scan can be done with TC99m Pertechnetate also in place of 123I.

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