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K H Davis1, C Happel1, R du Mesnil de Rochemont2

  • 1Universitätsklinikum Frankfurt; Klinik für Nuklearmedizin.

Nuklearmedizin. Nuclear Medicine
|May 30, 2019
PubMed
Summary
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A patient with a history of thyroid cancer developed primary hyperparathyroidism after treatment for medulloblastoma. Selective neck vein catheterization successfully located the parathyroid adenoma when imaging failed.

Area of Science:

  • Endocrinology
  • Oncology
  • Nuclear Medicine

Background:

  • A patient with a history of medulloblastoma treated with radiochemotherapy developed thyroid cancer.
  • Following surgery for thyroid cancer, the patient experienced long-term postsurgical hypoparathyroidism.
  • Ten years later, the patient presented with primary hyperparathyroidism.

Purpose of the Study:

  • To report a case of primary hyperparathyroidism in a patient with a complex medical history.
  • To highlight the diagnostic challenges in identifying the source of hyperparathyroidism.
  • To evaluate the utility of selective neck vein catheterization in diagnosing parathyroid adenoma.

Main Methods:

  • Review of patient's medical history, including medulloblastoma treatment and thyroid cancer.

Related Experiment Videos

  • Utilized established imaging modalities to detect the parathyroid adenoma.
  • Performed selective neck vein catheterization for parathyroid hormone-level sampling.

    • Main Results:

    • Standard imaging techniques were unsuccessful in locating the parathyroid adenoma.
    • Selective neck vein catheterization successfully identified the parathyroid adenoma as the cause of hyperparathyroidism.
    • The patient had slightly elevated parathyroid hormone levels.

    Conclusions:

    • Selective neck vein catheterization is a valuable tool for diagnosing primary hyperparathyroidism, especially when imaging is inconclusive.
    • This method is particularly useful for detecting small or ectopic parathyroid adenomas.
    • Early diagnosis and intervention are crucial for managing hyperparathyroidism in patients with a history of head and neck radiation.