Parathyroid adenoma

Case contributed by Dr Jan Frank Gerstenmaier

Presentation

Hyperparathyroidism

Patient Data

Age: 63
Gender: Male
Ultrasound

Parathyroid ultrasound

Reference is made to the examination from 12 February, 2015. Corresponding to the soft tissue nodule posteroinferior to the left thyroid lobe demonstrating intense radiotracer uptake, there is a circumscribed intermediate echogenicity nodule measuring 14 mm, displaying internal colour Doppler signal, in keeping with a parathyroid adenoma.

Nuclear medicine

Tc-99m MIBI SPECT

99mTc Sestamibi,

875 MBq

CLINICAL INDICATION

Hyperparathyroidism for localisation.

TECHNICAL PROCEDURE AND RESULTS

Static and SPECT images were acquired at 15 min and 3 hours. Delayed CT-SPECT was performed.

Initial images show prominent activity at the inferior aspect of the left thyroid lobe. The rest of the thyroid gland shows uniform uptake.

Delayed images show focally retained activity at the inferior aspect of the left thyroid lobe lower pole. SPECT/CT localises this focal uptake to an intensely Sestamibi-avid soft tissue nodule posteroinferior to the left thyroid lobe, adjacent to T1 vertebral body. The rest of the thyroid gland exhibits normal tracer washout. No other abnormal uptake is detected in the neck or thorax.

OVERALL IMPRESSION

Intensely Sestamibi-avid soft tissue nodule posteroinferior to the left thyroid lobe is consistent with a left lower parathyroid adenoma.

 

Case Discussion

There is good anatomical correlation between the SPECT and ultrasound localising the parathyroid adenoma at the lower pole of the left thryoid gland.

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Case information

rID: 34380
Case created: 17th Feb 2015
Last edited: 14th Dec 2015
System: Head & Neck
Inclusion in quiz mode: Included

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