DOI: 10.36347/sjmcr.2023.v11i03.026

Pages: 350-353

Introduction: Autonomously hyperfunctioning thyroid nodules, also known as "hot nodules", are defined by increased uptake of radiotracers compared to the surrounding thyroid parenchyma on scintigraphy. It has been believed that hot nodules have a low rate of malignancy, while an increasing number of thyroid carcinoma cases are being diagnosed in patients with hyperthyroidism. Case Presentation: A. J, a 50-year-old patient. She presented with signs of hyperthyroidism. Laboratory tests showed peripheral hyperthyroidism with an inhibited TSH of 0.03 μIU/ml and T4L of 37 pmol/L. The scintigraphy revealed a focus of hyper fixation almost completely affecting the right lobe which corresponded to a hot nodule most likely pre-extincted in the remaining parenchyma. The patient was initiated on synthetic antithyroid medication and, after achieving euthyroidism, she was referred to surgery. Right loboishmectomy was performed. The histological study revealed a 0.5 cm intralobular non-encapsulated microcarcinoma papillary on a background of thyroid dystrophy. Discussion: The initial evaluation of a thyroid nodule begins is the measurement of serum TSH and the performance of a thyroid ultrasound, followed by a thyroid radionuclide scan if the TSH is subnormal. Malignant nodules are usually non-functioning. The prevalence of malignancy associated with a hot nodule range between 1-10.3%. In many cases, thyroid cancer is not known preoperatively but is found incidentally during the postoperative histological examination of the thyroid. Most of these malignancies were of papillary carcinoma and less often follicular or Hurthle histological types, and they are small in size, and the majority are microcarcinomas. Conclusion: Further evaluation and characterization of the association between a hot thyroid nodule and malignancy are needed. In the case of our patient, the discovery of papillary carcinoma was incidental and was made during the postoperative histological examination .......