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Technetium-99m pertechnetate uptake in ectopic parathyroid adenoma
P O Kiratli1, I Peksoy, B Erbaş
1Department of Nuclear Medicine, Hacettepe University Medical School, Ankara, Turkey.
Annals of Nuclear Medicine
|June 4, 1999
Summary
This study highlights Tc-99m MIBI scintigraphy as a successful tool for locating ectopic parathyroid adenomas, even when they show unusual uptake of Tc-99m pertechnetate due to hypervascularity.
Area of Science:
- Nuclear medicine
- Endocrinology
- Surgical oncology
Background:
- Persistent hyperparathyroidism after thyroid and parathyroid surgery necessitates localization of potential ectopic parathyroid adenomas.
- Ectopic parathyroid tissue can present diagnostic challenges, particularly after prior surgical interventions.
Observation:
- A 37-year-old male post-thyroidectomy and parathyroidectomy presented with elevated parathyroid hormone levels.
- Both Tc-99m pertechnetate and Tc-99m MIBI scintigraphy demonstrated significant tracer uptake in the mediastinum.
- Surgical exploration confirmed an extrathyroidal parathyroid adenoma in the mediastinum.
Findings:
- The parathyroid adenoma exhibited avid uptake of both Tc-99m pertechnetate and Tc-99m MIBI.
- Hypervascularity is proposed as a potential reason for the rare pertechnetate avidity in parathyroid adenomas.
- Tc-99m MIBI scintigraphy was effective in the scintigraphic localization of this ectopic parathyroid adenoma.
Implications:
- Tc-99m MIBI scintigraphy is a valuable imaging modality for identifying ectopic parathyroid tissue in challenging clinical scenarios.
- Understanding tracer avidity patterns, including rare pertechnetate uptake, aids in accurate diagnosis and surgical planning.
- This case underscores the utility of nuclear imaging in managing persistent hyperparathyroidism post-surgery.