Abstract
Nodular thyroid disease arises from the increased proliferation rate of thyroid cells. Thyroid scintigraphy is considered as the gold standard imaging method for the diagnosis of thyroid nodules with autonomous function. Autonomously functioning thyroid nodules (AFTN) are defined as palpable nodules that are larger than 1 cm on ultrasonography demonstrating a focally increased uptake on thyroid scintigraphy. Practicing technetium scintigraphy for thyroid nodules is only recommended in the presence of suppressed or subnormal plasma TSH levels. However, this may result in underdiagnosis of these nodules in iodine-deficient countries. We hereby present a case with AFTN despite the presence of normal TSH values.
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References
Sarkar S. Benign thyroid disease: what is the role of nuclear medicine? Semin Nucl Med. 2006;36:185–93.
Lanni F, Perotti G, Prete A, Pargliola RM, Ricciato MP, Carrozza C, et al. Thyroid scintigraphy: an old tool is still the gold standard for an effective diagnosis of autonomously functioning thyroid nodules. J Endocrinol Investig. 2013;36:233–6.
Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26:1–178.
Tregelia G, Trimboli P, Verburg FA, Luster M, Giovanella L. Prevalence of normal TSH value among patients with autonomously functioning thyroid nodule. Eur J Clin Investig. 2015;45:739–44.
Gharib H, Papini E, Garber JR, Duick DS, Harrell RM, Hegedüs L, et al. American Associatıon of Clinical Endocrinologists, American College of Endocrinology, and Associazione Medici Endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules--2016 update. Endocr Pract. 2016;22:622–39.
Chami R, Moreno-Reyes R, Corvilain B. TSH measurement is not an appropriate screening test for autonomous functioning thyroid nodules: a retrospective study of 368 patients. Eur J Endocrinol. 2014;170:593–9.
Meller J, Becker W. The continuing importance of thyroid scintigraphy in the era of high-resolution ultrasound. Eur J Nucl Med Mol Imaging. 2002;29:425–38.
Vitti P, Delange F, Pinchera A, Zimmermann M, Dunn JT. Europe is iodine deficient. Lancet. 2003;361:1226–33.
Benoist B, Andersson M, Takkouche B, Egli I. Prevalence of iodine deficiency worldwide. Lancet. 2003;362:1859–60.
Mazzaferri EL. Management of solitary thyroid nodules. N Engl J Med. 1993;328:553–65.
Haentjens P, Van Meerhaeghe A, Poppe K, Velkeniers B. Subclinical thyroid dysfunction and mortality: an estimate of relative and absolute excess all-cause mortality based on time-to-event data from cohort studies. Eur J Endocrinol. 2008;159:329–41.
Giovanella L, D’Aurizio F, Campenni A, Ruggeri RM, Baldari S, Verburg FA, et al. Searching for the most effective thyrotropin (TSH) threshold to rule-out autonomously functioning thyroid nodules in iodine deficient regions. Endocrine. 2016;54:757–61.
Biersack HJ, Biermann K. The Marine-Lenhart syndrome revisited. Wien Klin Wochenschr. 2011;123:459–62.
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Altun, B.U., Yalın, G.Y. (2019). Toxic Multinodular Goiter in a Patient Who Has Been Followed Up with the Diagnosis of Hashimoto Thyroiditis and Has Normal TSH Values. In: Özülker, T., Adaş, M., Günay, S. (eds) Thyroid and Parathyroid Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-78476-2_4
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DOI: https://doi.org/10.1007/978-3-319-78476-2_4
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