Sachiko-Tsukamoto KawashimaDepartment of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Kyoto, Japan Department of Diabetes, Endocrinology and Metabolism Tango Central Hospital, Kyoto, Japan
asymptomatic hypercalcemia. Routine preoperative diagnostic tools, such as ultrasonography (US) or 99m technetium-sestamibi (99mTc-MIBI) scans, cannot clearly distinguish between these entities (2) . We report a hypercalcemic patient with a cervical cystic
impossible to exclude a malignancy on imaging alone. In order to exclude the possibility of a parathyroid carcinoma and treat her hypercalcaemia, she was referred for elective surgery.
Subtraction sestamibi nuclear medicine scan showing a
-abdominal CT scan were negative. A 99m Tc SestaMIBI WBS disclosed a well-delimited focal uptake in the distal region of the right femur ( Fig. 1 ). A FDG-PET/CT study performed after rhTSH stimulation showed lytic resorption in the left iliac crest, just above
Satish ArthamDepartment of Diabetes and Endocrinology, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK Department of Endocrinology and Diabetes, North Tees and Hartlepool Hospitals NHS Foundation Trust, Hartlepool, UK
ultrasonography, high-resolution computed tomography (CT) and technetium sestamibiscan of the neck. An ultrasound of the abdomen showed no nephrocalcinosis but a bone densitometry scan confirmed a diagnosis of osteoporosis which was mostly affecting the distal
, depression, and tiredness. Treatment of primary HPT in MEN1 patients usually involves preoperative localization of enlarged PGs, typically with ultrasonography (US) and a 99m Tc-sestamibi scintigraphy (MIBI) often combined with a single photon emission and a
ultrasound scan of the parathyroid glands and Technetium-99m sestamibi imaging confirmed an abnormal right upper parathyroid gland. The patient underwent a parathyroidectomy and the histology revealed a 15×12×18 mm parathyroid carcinoma extending to the
.06–0.45). 25-Hydroxycholecalciferol was 67 nmol/L (50–150 nmol/L). A parathyroid scan including pertechnate and Tc99m Sestamibi with early and delayed SPECT/CT of neck and mediastinum showed a solitary parathyroid adenoma in the lower pole of the left lobe of
Peter NovodvorskyDepartment of Diabetes and Endocrinology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
of conditions, the most common being solitary thyroid adenoma, followed by benign and malignant lesions of the neck, breast or lung, thymic lesions or reactive lymph nodes ( 13 ). Although the sensitivity of the 99m Tc sestamibiscan is high in
is limited in pregnancy as computed tomography and the gold standard 99mTc Sestamibiscan are contraindicated because of the radiation risk to the foetus, and therefore, ultrasound remains the only suitable radiological imaging modality in pregnancy
thyroid cyst. Six milliliters of serous fluid were aspirated, iPTH measurement from which revealed a level of 3480 pg/ml.
Tc 99m sestamibiscan did not reveal any functional parathyroid adenoma. Poor radiotracer uptake in the lower pole and