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We report a challenging case of relapsed hyperthyroidism in a woman who already underwent subtotal thyroidectomy in 1995 and surgical revision in 2020 for multinodular toxic goiter. <jats:sup>99m<\/jats:sup>Tc-pertechnetate scan revealed an area of radiotracer focal uptake at submandibular level, posing a differential diagnosis between salivary gland tumor and ectopic thyroid. Correlation with clinical history and ultimately histopathology led to diagnosis of hyperfunctioning submandibular ectopic tissue, successfully treating the patient with <jats:sup>131<\/jats:sup>I.<\/jats:p>","DOI":"10.1097\/rlu.0000000000005477","type":"journal-article","created":{"date-parts":[[2024,10,4]],"date-time":"2024-10-04T14:00:09Z","timestamp":1728050409000},"page":"e601-e603","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["A Challenging Case of Hyperfunctioning Submandibular Ectopic Thyroid Successfully Treated With 131I"],"prefix":"10.1097","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9627-5065","authenticated-orcid":false,"given":"Giusi","family":"Pisano","sequence":"first","affiliation":[{"name":"Section of Nuclear Medicine, University Department of Radiological Sciences and Haematology, Universit\u00e0 Cattolica del Sacro Cuore, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serena","family":"Sassano","sequence":"additional","affiliation":[{"name":"Section of Nuclear Medicine, University Department of Radiological Sciences and Haematology, Universit\u00e0 Cattolica del Sacro Cuore, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther Diana","family":"Rossi","sequence":"additional","affiliation":[{"name":"Division of Anatomic Pathology and Histology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annamaria","family":"D'Amore","sequence":"additional","affiliation":[{"name":"Division of Endocrine and Metabolic Surgery, Department of Medical Abdominal Surgical and Endocrine-Metabolic Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Zagaria","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2023,10,3]]},"reference":[{"key":"bib1-20250621","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1530\/EJE-11-0461","article-title":"Ectopic thyroid tissue: anatomical, clinical, and surgical implications of a rare entity","volume":"165","year":"2011","journal-title":"Eur J Endocrinol"},{"key":"bib2-20250621","doi-asserted-by":"crossref","first-page":"2684","DOI":"10.1210\/jc.2011-0611","article-title":"Clinical review: ectopic cervical thyroid carcinoma\u2014review of the literature with illustrative case series","volume":"96","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"key":"bib3-20250621","first-page":"9707031","article-title":"Papillary thyroid carcinoma: ectopic malignancy versus metastatic disease","volume":"2017","year":"2017","journal-title":"Case Rep Endocrinol"},{"key":"bib4-20250621","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1210\/er.2003-0028","article-title":"Thyroid development and its disorders: genetics and molecular mechanisms","volume":"25","year":"2004","journal-title":"Endocr Rev"},{"key":"bib5-20250621","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1097\/RLU.0000000000001401","article-title":"A rare case of lateral ectopic thyroid","volume":"41","year":"2016","journal-title":"Clin Nucl Med"},{"key":"bib6-20250621","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1016\/0278-2391(84)90228-3","article-title":"Evaluation of salivary gland tumors with 99mTc-pertechnetate","volume":"42","year":"1984","journal-title":"J Oral Maxillofac Surg"},{"key":"bib7-20250621","first-page":"43","article-title":"Diagnostic accuracy of technetium-99m-pertechnetate scintigraphy with lemon juice stimulation to evaluate Warthin's tumor","volume":"39","year":"1998","journal-title":"J Nucl Med"},{"key":"bib8-20250621","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1016\/j.anl.2014.08.002","article-title":"99mTcO4-accumulation in scintigraphy and expression of Na+\/I\u2212 symporter in salivary gland tumors","volume":"41","year":"2014","journal-title":"Auris Nasus Larynx"},{"key":"bib9-20250621","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1016\/j.ijsu.2014.05.076","article-title":"Morphological, diagnostic and surgical features of ectopic thyroid gland: a review of literature","volume":"12","year":"2014","journal-title":"Int J Surg"},{"key":"bib10-20250621","article-title":"Massive lateral neck mass: aberrant ectopic thyroid malignancy","volume":"14","year":"2021","journal-title":"BMJ Case Rep"},{"key":"bib11-20250621","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1159\/000490854","article-title":"H\u00fcrthle cell carcinoma in a lingual thyroid","volume":"27","year":"2018","journal-title":"Med Princ Pract"}],"container-title":["Clinical Nuclear Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/RLU.0000000000005477","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,21]],"date-time":"2025-06-21T19:07:17Z","timestamp":1750532837000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/RLU.0000000000005477"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,3]]},"references-count":11,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.1097\/rlu.0000000000005477","relation":{},"ISSN":["1536-0229","0363-9762"],"issn-type":[{"type":"electronic","value":"1536-0229"},{"type":"print","value":"0363-9762"}],"subject":[],"published":{"date-parts":[[2023,10,3]]}}}