Ectopic Submandibular Parathyroid Adenoma by Tc-99m Sestamibi SPECT/CT Localization

Area of Science:

• Endocrinology
• Nuclear Medicine
• Radiology

Background:

• Primary hyperparathyroidism is characterized by elevated parathyroid hormone and calcium levels.
• Accurate localization of parathyroid adenomas is crucial for surgical planning.

Observation:

• A 74-year-old female patient presented with symptoms of primary hyperparathyroidism.
• Technetium-99m-methoxyisobutyl isonitrile (sestamibi) planar imaging revealed an unusual focus of uptake in the right submandibular gland.

Findings:

• Single-photon emission computed tomography with CT (SPECT/CT) confirmed the parathyroid adenoma's location within the inferior aspect of the right submandibular gland.
• This finding represents an ectopic parathyroid adenoma in an uncommon location.

Implications:

• Ectopic parathyroid adenomas can mimic other head and neck pathologies, necessitating advanced imaging techniques.
• Accurate localization using sestamibi SPECT/CT is vital for successful minimally invasive parathyroidectomy, even in rare anatomical locations.