Hyperfunctioning Papillary Microcarcinoma Diagnosed by 124I PET/Ultrasound Fusion ImagingSeifert, Philipp, MD; Gühne, Falk, MD; Freesmeyer, Martin, MDClinical Nuclear Medicine: May 2019 - Volume 44 - Issue 5 - p 404–405 doi: 10.1097/RLU.0000000000002503 Interesting Images Buy SDC Abstract Author InformationAuthors Article MetricsMetrics A 49-year-old woman presented with a multinodular goiter, causing local symptoms and hyperthyroisdism. Besides a hypofunctioning benign nodule (TIRADS 3, benign in FNAC), the conventional diagnostic revealed another small hyperfunctioning nodule with suspicious ultrasound features (TIRADS 4C). To rule out a trapping-only nodule and topographical misalignments, a 124I PET/ultrasound fusion was performed and confirmed elevated iodine uptake within the suspicious nodule. Further disseminated autonomous areas are suspected to be additionally responsible for the low TSH-level. Because of the local cervical symptoms and the hyperthyroidism, the patient underwent surgery. The small hyperfunctioning nodule turned out to be a classic papillary microcarcinoma. From the Clinic of Nuclear Medicine, Jena University Hospital, Jena, Germany. Received for publication October 18, 2018; revision accepted January 10, 2019. Conflicts of interest and sources of funding: none declared. Correspondence to: Martin Freesmeyer, MD, Clinic of Nuclear Medicine, Jena University Hospital, Am Klinikum 1, 07747 Jena, Germany. E-mail: email@example.com. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.