Skip to main content
SpringerLink
Log in

Detection of ectopic parathyroid adenoma by early Tc-99m sestamibi imaging

  • Case Report
  • Published:
Annals of Nuclear Medicine Aims and scope Submit manuscript

Abstract

Localization of Tc-99m sestamibi (MIBI) by parathyroid adenomas (PA) is well known. Typically the radionuclide washes out slowly from the PAs located in the neck. Rapid washout from some PAs has been reported. Various hypotheses have been postulated for slow and rapid clearance of MIBI from PAs, located in the neck. However, the washout of MIBI from ectopic parathyroid adenoma (EPA) in not well reported. We present a case of EPA with rapid washout of MIBI. Hence, early MIBI imaging plays an important role in the evaluation of EPA.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Bienvenu M, Amar L, Vignaux O, Fulla Y, Bonnichon P, Richard B, et al. Diagnosis of ectopic mediastinal parathyroid adenomas: value of cardiac MRI.J Radiol 2003; 84: 1969–1973.

    PubMed  CAS  Google Scholar 

  2. Itoh K, Ishizuka R. Tc-99m-MIBI scintigraphy for recurrent hyperparathyroidism after total parathyroidectomy with autograft.Ann Nucl Med 2003; 17: 315–320.

    Article  PubMed  Google Scholar 

  3. Ng P, Lenzo NP, McCarthy MC, Thompson I, Leeman PJ. Ectopic parathyroid adenoma localized with sestamibi SPECT and image-fused computed tomography.Med J Aust 2003; 179: 485–87.

    PubMed  Google Scholar 

  4. Rubello D, Casara D, Fiore D, Muzzio P, Zonzin G, Shapiro B. An ectopic mediastinal parathyroid adenoma accurately located by a single-day imaging protocol of Tc-99m pertechnetate-MIBI subtraction scintigraphy and MIBI-SPECT-computed tomographic image fusion.Clin Nucl Med 2002;27: 186–190.

    Article  PubMed  Google Scholar 

  5. Saky MT, Hasinski S, Rose LI. Ectopic primary hyperparathyroidism.Endocr Pract 2001; 7: 272–274.

    PubMed  CAS  Google Scholar 

  6. Unnikishnan AG, Seshadri MS, Rajaratnam S, Krishnaveni, Nair A, Shanthly N.99mTc-Sestamibi scan in a patient with an ectopic parathyroid adenoma.J Assoc Physicians India 2000; 48: 1113–1115.

    Google Scholar 

  7. Sofferman RA, Nathan MH. The ectopic parathyroid adenoma: a cost justification for routine preoperative local- ization with technetium Tc 99m sestamibi scan.Arch Otolaryngol Head Neck Surg 1998; 124: 649–654.

    Article  PubMed  CAS  Google Scholar 

  8. Berna L, Caixas A, Piera J, Gomez G, Matias-Guiu X, Estorch M, et al. Technetium-99m methoxyisobutylisonitrile in localization of ectopic parathyroid adenoma.J Nucl Med 1996; 37: 631–633.

    PubMed  CAS  Google Scholar 

  9. Ozalp E, Bluemke D, Civelek AC. (99m)Tc sestamibi accumulation in the chest mimicking an ectopic parathyroid adenoma.Semin Nucl Med 2002; 32: 223–227.

    Article  PubMed  Google Scholar 

  10. Batsakis C, Kalkana C, Ilias I, Panoutsopoulos G, Christakopoulou I. Giant Mediastinal Parathyroid Adenoma in a Woman with Hypercalcemia.Clin Nucl Med 2001; 26: 950–951.

    Article  PubMed  CAS  Google Scholar 

  11. Sahin M, Er C, Unlu Y, Tekin S, Seker M. An ectopic parathyroid gland in the left axillary region; case report.Int Surg 2004; 89: 6–9.

    PubMed  Google Scholar 

  12. Adams BK, Devi RT, Al-Haider ZY. Tc-99m sestamibi localization of an ectopic mediastinal parathyroid tumor in a patient with primary hyperparathyroidism.Clin Nucl Med 2004; 29: 388–389.

    Article  PubMed  Google Scholar 

  13. Bozkurt MF, Ugur O, Hamaloglu E, Sayek I, Gulec SA. Optimization of the gamma probe-guided parathyroidec- tomy.Am Surg 2003; 69: 720–725.

    PubMed  Google Scholar 

  14. Hiromatsu Y, Ishibashi M, Nishida H, Okuda S, Miyake I. Technetium-99m tetrofosmin parathyroid imaging in patients with primary hyperparathyroidism.Intern Med 2003; 39: 101–106.

    Article  Google Scholar 

  15. Morbois-Trabut L, Saad N, Gervaise N, Legmann P, Lecomte P. Diagnostic strategy in persistent hyperparathyroidism. Report of two cases and review of the literature.Ann Endocrinol 2002; 63: 18–22.

    CAS  Google Scholar 

  16. Boggs JE, Irvin GL 3rd, Carneiro DM, Molinari AS. The evolution of parathyroidectomy failures.Surgery 1999; 126: 998–1002.

    Article  PubMed  CAS  Google Scholar 

  17. Quiros RM, Warren W, Prinz RA. Excision of a mediastinal parathyroid gland with use of video-assisted thoracoscopy, intraoperative99mTc-sestamibi scanning and intraoperative monitoring of intact parathyroid hormone.Endocr Pract 2004; 10: 45–48.

    PubMed  Google Scholar 

  18. Pinero A, Rodriguez JM, Martinez-Barba E, Cameras M, Stiges-Serra A, Parrilla P. Tc99m-sestamibi scintigraphy and cell proliferation in primary hyperparathyroidism: a causal or casual relationship?Surgery 2003; 134: 41–44.

    Article  PubMed  Google Scholar 

  19. Otto D, Boerner AR, Hofmann M, Brunkhorst T, Meyer GJ, Petrick T, et al. Preoperative localization of hyperfunctional parathyroid tissue with (1 l)C-methionine PET.Eur J Nucl Med Mol Imaging 2004; 31: 1405–1412.

    Article  PubMed  CAS  Google Scholar 

  20. Apostolopoulos DJ, Houstoulaki E, Giannakenas C, Alexandrides T, Spiliotis J, Nikiforidis G, et al. Techne- tium-99m tetrofosmin for parathyroid scintigraphy: comparison to thallium-technetium scanning.J Nucl Med 1998; 39: 1433–1441.

    PubMed  CAS  Google Scholar 

  21. Onoda N, Ishikawa T, Yamada N, Okamura T, Tahara H, Inaba M, et al. Radioisotope-navigated video-assisted tho- racoscopic operation for ectopic mediastinal parathyroid.Surgery 2002; 132: 17–19.

    Article  PubMed  Google Scholar 

  22. Profanter C, Schmid T, Prommegger R, Bale R, Sauper T, Bodner J. Robot-assisted mediastinal parathyroidectomy.Surg Endosc 2004; 18: 868–870.

    Article  PubMed  CAS  Google Scholar 

  23. Amar L, Guignat L, Tissier F, Richard B, Vignaux O, Fulla Y, et al. Video-assisted thoracoscopic surgery as a first-line treatment for mediastinal parathyroid adenomas: strategic value of imaging.Eur J Endocrinol 2004; 150: 141–147.

    Article  PubMed  CAS  Google Scholar 

  24. Spanu A, Falchi A, Manca A, Marongiu P, Cossu A, Pisu N, et al. The usefulness of neck pinhole SPECT as a complementary tool planar scintigraphy in primary and secondary hyperparathyroidism.J Nucl Med 2004; 45: 40–48.

    PubMed  Google Scholar 

  25. Leslie WD, Riese KT, Dupont JO, Peterdy AE. Parathyroid adenomas without sestamibi retention.Clin Nucl Med 1995; 20: 699–702.

    Article  PubMed  CAS  Google Scholar 

  26. Bernard F, Lefebvre B, Beuvon F, Langlois MF, Bisson G. Rapid washout of technetium-99m-MIBI from a large parathyroid adenoma.J Nucl Med 1995; 36: 241–243.

    Google Scholar 

  27. Staudenherz A, Kletter K, Leitha TH. Rapid washout of technetium-99m-MIBI from a large parathyroid adenoma.J Nucl Med 1995; 36: 1928–1929.

    PubMed  CAS  Google Scholar 

  28. Smith JR, Oates ME. Radionuclide imaging of the parathyroid glands: patterns, pearls, and pitfalls.Radiographic 2004; 24: 1101–1115.

    Article  Google Scholar 

  29. Pinero A, Rodriguez JM, Ortiz S, Soria T, Bermejo J, Claver MA, et al. Relation of biochemical, cytologic, and morphologic parameters the result of gammagraphy with technetium 99m sestamibi in primary hyperparathyroidism.Otolaryngol Head Neck Surg 2000; 122: 851–855.

    Article  PubMed  CAS  Google Scholar 

  30. Rubello D, Piotto A, Pagetta C, Pelizzo M, Casara D. Ectopic Parathyroid Adenomas Located at the Carotid Bifurcation: The Role of Preoperative Tc-99m MIBI Scintigraphy and the Intraoperative Gamma Probe Procedure in Surgical Treatment Planning.Clin Nucl Med 2001; 26: 774–776.

    Article  PubMed  CAS  Google Scholar 

  31. Axelrod D, Sisson JC, Cho K, Miskulin J, Gauger PG. Appearance of ectopic undescended inferior parathyroid adenomas on technetium Tc 99m sestamibi scintigraphy: a lesson from reoperative parathyroidectomy.Arch Surg 2003; 138: 1214–1218.

    Article  PubMed  Google Scholar 

  32. Perez-Monte JE, Brown ML, Shad AN, Ranger NT, Watson CG, Carty S, et al. Parathyroid adenomas: accurate and localization with Tc 99m sestamibi SPECT.Radiology 1996; 201: 85–91.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Nuclear Medicine Section, Department of Radiology, UTMB, Galveston, TX, USA

    Vani Vijayakumar & Matthew E. Anderson

Authors
  1. Vani Vijayakumar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Matthew E. Anderson
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Vani Vijayakumar.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Vijayakumar, V., Anderson, M.E. Detection of ectopic parathyroid adenoma by early Tc-99m sestamibi imaging. Ann Nucl Med 19, 157–159 (2005). https://doi.org/10.1007/BF03027396

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03027396

Key words

Search

Navigation