Parathyroid Adenoma Detected in ⁶⁸Ga-PSMA PET/CT but Not in the Dedicated Imaging Modalities

Primary hyperparathyroidism is a common endocrine disorder characterised by excessive parathormone secretion that results in hypercalcemia, primarily caused by parathyroid adenoma. Accurate localisation of hyperfunctioning tissue is essential for curative surgical treatment. Although conventional imaging modalities like ultrasonography and ^99mTc-MIBI scintigraphy (SPECT) along with ¹⁸F-fluorocholine PET/CT are commonly employed, there are cases with false-negative imaging results.

This case report presents a patient with primary hyperparathyroidism and a parathyroid adenoma detected solely through ⁶⁸Ga-PSMA-11 PET/CT, typically used for prostate cancer diagnosis. The lesion observed in the PET/CT was confirmed as a parathyroid adenoma through laboratory evaluation, while other imaging techniques failed to detect it.

This finding suggests that the PSMA ligands' particular affinity for neovascularisation in focal changes may facilitate the visualisation of parathyroid adenomas. The utilisation of ⁶⁸Ga-PSMA-11 PET/CT in primary hyperparathyroidism could potentially improve the preoperative localization of parathyroid adenomas when conventional imaging methods are inconclusive.