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Subacute Thyroiditis (de Quervain) Presenting a Painless "Cold" Nodule

St. Franciscus Hospital, Department of Nuclear Medicine, The Netherlands

Correspondence: For reprints contact: Robbert O. Boer, St. Franciscus Hospital, Dept. of Nucl. Medicine, Boerhaavelaan 25, 4708 AE Roosendaal, The Netherlands.

ABSTRACT

A 49-yr-old woman presented with a solid, painless, nontender nodule in the left thyroid lobe. Thyroid scintigraphy revealed a solitary "cold" area in the left lobe and a slightly decreased 24-hr radioactive iodine thyroid uptake (9%). Although there were no specific clinical or biochemical signs suggesting thyroiditis needle aspiration cytology showed the presence of a subacute thyroiditis. Approximately 1 mo later the entire thyroid gland was affected leading to a completely suppressed thyroid radioiodine uptake and elevated serum thyroid hormone concentrations. This case illustrates that in the early phase of the disease, subacute thyroiditis may present as a solitary, painless, "cold" nodule and should be considered in the differential diagnosis of such lesions.