|Patient: 56 year old female|
56-year-old woman with elevated calcium and parathyroid hormone levels
RADIOPHARMACEUTICAL: 19.6 mCi Tc-99m sestamibi i.v.
|DDx: DIFFERENTIAL DIAGNOSIS:|
Hypercellular parathyroid, parathyroid adenoma, parathyroid hyperplasia, parathyroid cancer, thyroid adenoma
|Diagnosis: Hypercellualr parathyroid gland was removed from the right side at surgery|
General Discussion: FOLLOW-UP:|
The patient returns 4 months later, again with elevated calcium levels (11.1 mg/dl). Parathyroid scan was performed and focus of increased activity was seen inferior to the left lower pole of the thyroid gland. Subsequently, a CT examination was performed, which demostrated a second parathyroid adenoma. Surgical exploration was performed and the left lower hypercellular parathyroid gland was removed. Intraoperative PTH went down from 139 pg/mL to 21 pg/mL, 10 minutes after the removal of the gland.
|Specific Discussion: Multiple parathyroid adenomas are very uncommon, but were clearly present in this case. Reports vary, but up to 4% of cases may have more than one adenoma*|
|References: Surgery: 108:1014-1019, 1990.|
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Case Number: 93369Owner(s): Keith Fischer and Asif MoinuddinLast Updated: 12-15-2010 The reader is fully responsible for confirming the accuracy of this content.
The reader is fully responsible for confirming the accuracy of this content.