Case Author(s): J. Wallis , 4/20/95 . Rating: #D4, #Q2
Diagnosis: Small parathyroid adenoma
Brief history:
Elevated serum calcium
Images:
(left) Initial 10 min images and (right)
delayed images at 2 hrs. Below is shown
an enlarged version of the delayed image.
View main image(pa) in a separate image viewer
Full history/Diagnosis is available below
Diagnosis: Small parathyroid adenoma
Full history:
The study was obtained pre-operatively for localization of
a parathyroid adenoma
Radiopharmaceutical:
Tc-99m Sestamibi
Findings:
Normal clearance of tracer is seen from the thyroid gland.
On initial images, the inferior right pole appears to
extend slightly lower than the contralateral side.
On delayed images, there is subtle retension of tracer
in this inferior right pole region.
Discussion:
This case is at the limit of resolution of the
scintigraphic
technique. Although this subtle a finding is not as
definitive as would be seen with larger lesions, it can provide
a starting point for the surgical exploration.
Followup:
On surgical exploration, a 1.2 x 1.5 cm parathyroid
adenoma was
found at the inferior margin of the right lobe of
the thyroid, corresponding to the scintigraphic
findings.
ACR Codes and Keywords:
References and General Discussion of Parathyroid Scintigraphy (Anatomic field:Face, Mastoids, and Neck, Category:Metabolic, endocrine, toxic)
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Case number: pa003
Copyright by Wash U MO