Case Author(s): Charles Pringle/Henry Royal , 9/14/95 . Rating: #D1, #Q3

Diagnosis: parathyroid adenoma

Brief history:

Hyperparathyroidism status post total thyroidectomy.


Anterior Neck (initial and 2 hour delayed images)

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View second image(us). Ultrasound - transverse right lower neck

Full history/Diagnosis is available below

Diagnosis: parathyroid adenoma

Full history:

65-year old woman with primary hyperparathyroidism status post total thyroidectomy, now being evaluated for parathyroid adenoma.


Tc-99m Sestamibi


Immediate static images of the parathyroid scintigraphy reveal increased activity in the inferior left thyroid bed and another focus of increased activity at the medial aspect of the right clavicle. The focus of activity at the medial aspect of the right clavicle has persistently increased activity on the 2-hour delayed images. This is consistent with a parathyroid adenoma. The second focus of activity in the region of the left inferior thyroid bed shows gradually decreasing activity, most consistent with residual thyroid.


Neck ultrasound also revealed an area of residual soft tissue in the left thyroid bed with an appearance most consistent with residual native thyroid tissue. In the right neck inferiorly, there was a hypoechoic mass immediately medial to the junction of the common carotid artery and innominate artery. The sonographic characteristics were most consistent with a parathyroid lesion or, less likely, enlarged lymph node.


The patient underwent surgery on 7-3-95, at which time the right lower parathyroid gland was removed. Pathology was consistent with a parathyroid adenoma.

ACR Codes and Keywords:

References and General Discussion of Parathyroid Scintigraphy (Anatomic field:Face, Mastoids, and Neck, Category:Neoplasm, Neoplastic-like condition)

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Case number: pa004

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