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LETTER TO THE EDITOR
Year : 2012  |  Volume : 16  |  Issue : 6  |  Page : 1056

'Hockey stick' sign on 99m Technetium pertechnetate thyroid scan


Department of Nuclear Medicine, AIIMS, New Delhi, India

Date of Web Publication31-Oct-2012

Correspondence Address:
Nishikant A Damle
Department of Nuclear Medicine, AIIMS, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2230-8210.103045

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How to cite this article:
Damle NA, Bal C, Sahoo M, Jain T, Mishra A. 'Hockey stick' sign on 99m Technetium pertechnetate thyroid scan. Indian J Endocr Metab 2012;16:1056

How to cite this URL:
Damle NA, Bal C, Sahoo M, Jain T, Mishra A. 'Hockey stick' sign on 99m Technetium pertechnetate thyroid scan. Indian J Endocr Metab [serial online] 2012 [cited 2019 Nov 18];16:1056. Available from: http://www.ijem.in/text.asp?2012/16/6/1056/103045

Sir,

Thyroid hemiagenesis is a very rare congenital abnormality, in which one thyroid lobe fails to develop. The true prevalence of thyroid hemiagenesis is not known, because the absence of one thyroid lobe does not usually cause clinical symptoms. The detection of hemiagenesis is usually incidental, when the evaluation of other thyroid disorders is requested. Hemiagenesis is estimated to be prevalent in about 0.02% of normal children. [1],[2]

We present the 99 mTc-pertechnetate thyroid scan findings of a 17-year-old female patient, who presented with a history of neck pain of recent onset, radiating to the parotid region. She was referred for a thyroid scan to rule out subacute thyroiditis. She underwent a thyroid scan 20 minutes after intravenous administration of 5 mCi of 99 mTc-pertechnetate, and it revealed a classical 'Hockey Stick' appearance, suggestive of hemiagenesis of the thyroid, with absent left lobe and normal right lobe and isthmus [Figure 1]. The scan also ruled out subacute thyroiditis. The scan findings were subsequently corroborated by a neck ultrasound.
Figure 1: Classical 'Hockey Stick' appearance on 99mTc-pertechnetate thyroid scan suggestive of hemiagenesis of the thyroid with absent left lobe and normal right lobe and isthmus (Figure 1). The scan also ruled out subacute thyroiditis

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Thyroidal hemiagenesis, with an isthmus present, has the appearance of a hockey stick on a 99mTc-pertechnetate thyroid scan. Absence of the left lobe is more common with a ratio of about 4: 1. A female to male ratio of 3: 1 is seen. Associated diseases reported in the existing thyroid lobe include differentiated thyroid cancer, hyperthyroidism, primary and secondary hypothyroidism, benign adenoma, multinodular goiter, hyperparathyroidism, and chronic thyroiditis. Some patients are found to be in a euthyroid state without any other abnormalities as in our reported case. [3] The most common disease of the remaining lobe is hyperthyroidism.

 
   References Top

1.Karabay N, Comlekci A, Canda MS, Bayraktar F, Degirmenci B. Thyroid hemiagenesis with multinodular goiter: A case report and review of the literature. Endocr J 2003;50:409-13.  Back to cited text no. 1
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2.Pizzini AM, Papi G, Corrado S, Carani C, Roti E. Thyroid hemiagenesis and incidentally discovered papillary thyroid cancer: Case report and review of the literature. J Endocrinol Invest 2005;28:66-71.  Back to cited text no. 2
[PUBMED]    
3.Melnick JC, Stemkowski PE. Thyroid hemiagenesis (hockey stick sign): A review of the world literature and a report of four cases. J Clin Endocrinol Metab 1981;52:247-51.  Back to cited text no. 3
[PUBMED]    


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