Thyroid imaging with iodine-131 (131I) and technetium pertechnetate (99mTc04) have proved to be useful procedures in delineating thyroid nodules (1). The two techniques usually yield identical images (2). Discrepancies in imaging between 131I (“cold”) and with 99mTc04 (“hot”) have been reported (1, 3–5). Among the pathology of nodules with discordant imaging were Hashimoto's thyroiditis, trabecular adenoma, Hurthle cell adenoma, thyroid carcinoma, and multinodular goiter. We report a case in which a parathyroid adenoma presented as a “cold” nodule on 131I scan and “hot” on 99mTc04 scan.
A 60-year-old woman with diabetes mellitus and hypertension of 20 years' duration was admitted