The Occurrence of Carcinoma in "Hot" Thyroid Nodules

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Abstract
It is generally accepted that thyroid nodules showing hyperfunction on the scintogram are not malignant. Exceptions to this general rule do occur and two patients with solitary hyperfunctioning thyroid nodules which histologically revealed papillary carcinoma within an adenoma are presented. Radioautographs show no uptake over the tumor cells but increased uptake in the surrounding parenchyma. The first patient had a hard thyroid nodule and symptoms suggestive of hyperthyroidism but without other physical or laboratory findings to support this diagnosis. The clinical impression was malignancy. The second patient was asymptomatic except for a thyroid nodule, which did not suppress with L-tri-iodothyronine, suggesting that the nodule was autonomous. Surgery was performed in each instance as a result of total clinical evaluation rather than reliance on the results of the scintogram alone. Although it seems likely that the presence of malignancies within hyper-functioning nodules is rare, the finding of a "hot" nodule does not, of itself, preclude a diagnosis of carcinoma.

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