Synchronous parathyroid adenoma and papillary thyroid carcinoma: 99mTc-MIBI Scan Findings

Area of Science:

• Endocrinology
• Nuclear Medicine
• Oncology

Background:

• Primary hyperparathyroidism (PHPT) is often caused by parathyroid adenoma.
• Co-occurrence of parathyroid adenoma and thyroid carcinoma is infrequent.
• Accurate preoperative diagnosis is essential for managing hyperparathyroidism and associated conditions.

Observation:

• A 52-year-old female with PHPT underwent Tc-99m MIBI scintigraphy.
• Scintigraphy revealed activity in both the thyroid and parathyroid regions.
• Subsequent thyroid scintigraphy and fine-needle aspiration suggested a thyroid nodule.

Findings:

• Parathyroid adenoma was localized to the left lobe's lower pole neighborhood.
• A separate thyroid nodule was identified, requiring further investigation.
• The case demonstrates the rare simultaneous presence of parathyroid adenoma and nonmedullary thyroid carcinoma.

Implications:

• This case underscores the importance of thorough preoperative evaluation in PHPT patients.
• It highlights the potential for co-existing thyroid pathology, including cancer, in patients with parathyroid adenoma.
• Early detection and management of both conditions are critical for patient outcomes.