case_images: PMC11338776_01
case_images: The first thyroid ultrasound examination showing a solitary thyroid nodule with an LD of 17 mm in the left lobe.
case_images: fped-12-1388437-g001.jpg
case_images: PMC11338776_01_fped-12-1388437-g001.jpg
case_images: F1
case_images: Following the aforementioned finding, the child therefore underwent a thyroid ultrasound that documented the presence of a nodule in the left lobe [longitudinal diameter (LD), 17 mm] with a disomogeneous structure and microcalcifications, and without pathological findings at the color-Doppler evaluation (shown in Figure 1).
case_images: Thyroid scintigraphy: a scintigraphic exam documenting a hyperfunctioning nodule, as shown by the focal iodine-131 concentration on the nodule with suppression of the surrounding thyroid gland tissue.
case_images: fped-12-1388437-g002.jpg
case_images: PMC11338776_01_fped-12-1388437-g002.jpg
case_images: F2
case_images: Owing to the TSH suppression, a scintigraphic examination was carried out, which documented a defined focal uptake of iodine-123 in the nodule with suppressed uptake in the rest of the gland (shown in Figure 2).
case_images: Diagnostic and therapeutic timeline. T0, the patient came to our attention with a palpable thyroid mass with an LD of 17 mm at the US exam, within normal thyroid function. T1, A FNAB was conducted due to the ultrasound dimensions of the nodule; malign causes were excluded. T2, after 6 months, the nodule grew up to 22 mm in LD, with evidence of some risk factors at the US exam, and TSH suppression was documented; a second FNAB confirmed a non-malignant lesion (TIR2) and the thyroid scintigraphy documented a focal iodine-132 concentration on the nodule with suppression of the surrounding gland tissue. T3, the patient underwent hemithyroidectomy surgery. T4, the histological examination confirmed the diagnosis of PA. Lab, laboratory exams; US, ultrasound; FNAB, fine-needle aspiration biopsy; PA, Plummer's adenoma; TSH, thyroid-stimulating hormone.
case_images: fped-12-1388437-g003.jpg
case_images: PMC11338776_01_fped-12-1388437-g003.jpg
case_images: F3
case_images: Figure 3 shows the timeline from the first clinical finding of the thyroid nodule to the diagnosis of PA.