4DCT Differentiation of Parathyroid Adenoma: A Case Report
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Published on: June 9, 2023
Tana Bupe Mwewa1, Steven Raeymaeckers1
1UZ Brussel, Belgium.
Abstract:
We report the case of a 72-year-old patient presenting with recurrent primary hyperparathyroidism after total thyroidectomy and parathyroidectomy with presternal autotransplantation. Methionine-PET-CT proved false-positive and Tc-99m-tetrofosmine imaging false-negative. Using a novel multiphase-4DCT technique we identified an anterior mediastinal nodule demonstrating contrast wash-in and wash-out, suggesting parathyroid adenoma. Traditional 4DCT-protocols obtain fewer phases; therefore, this enhancement pattern might have gone unnoticed. After surgical resection the bloodwork normalized, histopathology confirmed a parathyroid adenoma.
Teaching Point:
Multiphase 4DCT is a potentially helpful technique for the detection of parathyroid adenomas after total thyroidectomy and parathyroidectomy.
