A 79-year-old woman with suspected choroidal lesion underwent 18 F-FDG PET/CT, which revealed a non–FDG-avid right thyroid lobe incidentaloma (4.8 cm in largest dimension) that was cold on 99m Tc-thyroid scan, showed intense SSTR expression on 68 Ga-DOTATATE PET/CT, and MIBG avidity on 131 I-MIBG scan, thereby proving it to be of neural crest origin. Fine needle aspiration biopsy (FNAB) with immunohistochemistry was positive for GATA3 and synaptophysin and negative for CK7, PAX8, TTF1, and calcitonin, establishing the diagnosis of thyroid paraganglioma. Even though rare, the diagnosis of paraganglioma should be considered in SSTR and MIBG-avid thyroid nodules, as seen in this case.
Garg et al. (Thu,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: