Skip to main content
SpringerLink
Log in

Thymic carcinoid and parathyroid hyperplasia detection with 99mTc-MIBI men type 1

  • Case Report
  • Published:
Journal of Endocrinological Investigation Aims and scope Submit manuscript

Abstract

We report a case of a 35-year-old male, with a history of diarrhea, renal lithiasis with frequent expulsions of calculus and hypercalcemia during the last 2 years. The patient was studied and diagnosed with a multiple endocrine neoplasia type I (MEN I), familiar (mother with MEN I). A scintigraphic study with 99mTc-MIBI was performed in order to localize hyperfunctioning parathyroid glands because of biochemical diagnosis of primary hyperparathyroidism. Double phase 99mTc-MIBI scan detected one hyperfunctioning parathyroid gland and a large anterior mediastinal mass. Subsequent, plain radiograph and CT of the chest showed a soft-tissue mass in that localization. Punch biopsy of the lesion guided by CT revealed malignant cells of neuroendocrine tumor. The tumor was removed and histologically confirmed as a carcinoid within a thymus in a MEN type I syndrome. MEN I patients can benefit from the examination with this agent which can potentially localize not only parathyroid endocrine pathology but also unknown associated tumors.

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. Holman B.L., Jones A.G., Lister-James J., Davidson A., Abrams M.J., Kirshenbaum J.M., Tumeh S.S., English R.J. A new Tc-99m-labeled myocardial imaging agent, hexakis (t-butylisonitrile) technetium(I) [Tc-99mTBI], initial experience in the human. J. Nucl. Med. 1984, 25: 1350–1355.

    CAS  PubMed  Google Scholar 

  2. Wackers F.J.T., Berman D.S., Maddahi J., Watson D.D., Beller G.A., Strauss H.W., Boucher C.A., Picard M., Holman B.L., Fridrich R. Technetium-99m hexakis 2-methoxy-isobutyl isonitrile: human biodistribution, dosimetry, safety, and preliminary comparison to thallium-201 for myocardial perfusion imaging. J. Nucl. Med. 1989, 30: 301–311.

    CAS  PubMed  Google Scholar 

  3. Chiu M.L., Kronauge J.F., Piwnica-Worms D. Effect of mitochondrial and plasma membrane potentials on accumulation of hexakis (2-methoxyisobutylisonitrile) technetium (I) in cultured mouse fibroblasts. J. Nucl. Med. 1990, 31: 1646–1653.

    CAS  PubMed  Google Scholar 

  4. Delmon-Moingeon L.I., Piwnica-Worms D., Van den Abbeele A.D., Holman B.L., Davison A., Jones A.G. Uptake of the cation hexakis (2-methoxisobutylisonitrile)- technetium-99m by human carcinoma cell lines in vitro. Cancer Res. 1990, 50: 2198–2202.

    CAS  PubMed  Google Scholar 

  5. Stefanescu C., Rusu V., Maublant J.C. An in-vitro study of 99mTc-sestamibi uptake by normal and neoplastic cell lines. Rev. Med. Chir. Soc. Med. Nat. Iasi 1995, 99: 116–123.

    CAS  PubMed  Google Scholar 

  6. Chen L.B. Mitochondrial membrane potentials in living cells. Ann. Rev. Cell. Biol. 1988, 4: 155–181.

    Article  CAS  PubMed  Google Scholar 

  7. Aktolun C., Bayhan H., Kir M. Clinical experience with Tc-99m MIBI imaging in patients with malignant tumors. Preliminary results and comparison with TI-201. Clin. Nucl. Med. 1992, 17: 171–176.

    Article  CAS  PubMed  Google Scholar 

  8. Beller G.A., Watson D.D. Physiological basis of myocardial perfusion imaging with the technetium 99m agents. Semin. Nucl. Med. 1991, 21: 173–181.

    Article  CAS  PubMed  Google Scholar 

  9. Coakley A.J., Kettle A.G., Wells C.P., O’Doherty M.J., Collins R.E.C. Tc-99m sestamibi — a new agent for parathyroid imaging. Nucl. Med. Commun. 1989, 10: 791–794.

    Article  CAS  PubMed  Google Scholar 

  10. O’Doherty M.J., Kettle A.G., Wells P., Collins R.E., Coackley A.J. Parathyroid imaging with technetium 99m-sestamibi: preoperative localization and tissue uptake studies. J. Nucl. Med. 1992, 33: 313–318.

    PubMed  Google Scholar 

  11. Taillefer R., Boucher Y., Potvin C., Lambert R. Detection and localization of parathyroid adenomas in patients with hyperparathyroidism using a single radionuclide imaging procedure with technetium- 99m sestamibi (double-phase study). J. Nucl. Med. 1992, 33: 1801–1807.

    CAS  PubMed  Google Scholar 

  12. Gagel R.F. Multiple endocrine neoplasia. In: Wilson J., Foster D. (Eds.), Williams Texbook of Endocrinology, ed. 8. W.B. Saunders, Philadelphia, PA, 1992, p. 1537.

    Google Scholar 

  13. Leshin M. Multiple endocrine neoplasia. In: Wilson J., Foster D. (Eds.), Williams Textbook of Endocrinology, ed. 7. W.B. Saunders, Philadelphia, PA, 1989, p. 1274.

    Google Scholar 

  14. Benson L., Ljunghall S., Akerstrom G., Oberg K. Hyperparathyroidism presenting as the first lesion in multiple endocrine neoplasia type I. Am. J. Med. 1987, 82: 731–737.

    Article  CAS  PubMed  Google Scholar 

  15. Skogseid B., Eriksson B., Lundquist G., Lorelius L.E., Rastad J., Wide L., Akerstrom G., Oberg K. Multiple endocrine neoplasia Type I: a 10-year prospective screening study in four kindreds. J. Clin. Endocrinol. Metab. 1991, 73: 281–287.

    Article  CAS  PubMed  Google Scholar 

  16. Van heerden J.A., KENT R.B. III, Sizemore G.W., Grant C.S., ReMine W.H. Primary hyperparathyroidism in patients with multiple endocrine neoplasia syndromes. Arch. Surg. 1983, 118: 533–536.

    Article  PubMed  Google Scholar 

  17. Underdahl L.O., Woolner L.B., Black B.M. Multiple endocrine adenomas. Report of 8 cases in which the parathyroid, pituitary and pancreatic islets were involved. J. Clin. Endocrinol. Metab. 1953, 13: 20–47.

    Article  CAS  PubMed  Google Scholar 

  18. Duh Q.Y., Hybarger C.P., Geist R., Gamsu G., Goodman P.C., Gooding G.A., Clark O.H. Carcinoid associated with multiple endocrine neoplasia syndromes. Am. J. Surg. 1987, 154: 142–148.

    Article  CAS  PubMed  Google Scholar 

  19. Zeiger M.A., Swartz S.E., MacGillivray D.C., Linnoila I., Shakir M. Thymic carcinoid in association with MEN syndromes. Am. Surg. 1992, 58: 430–434.

    CAS  PubMed  Google Scholar 

  20. Asbun H.J., Calabria P.P., Calmes S., Lang A.G., Bloch J.H. Thymic carcinoid. Am. Surg. 1991, 57: 442–445.

    CAS  PubMed  Google Scholar 

  21. Campeau R.J., Kronemer K.A., Sutherland C.M. Concordant uptake of the Tc-99m sestamibi and TI-201 in unsuspected breast tumor. Clin. Nucl. Med. 1992, 17: 936–937.

    Article  CAS  PubMed  Google Scholar 

  22. Strouse P.J., Wang D.C. Incidental detection of bronchogenic carcinoma during Tc-99m sestamibi cardiac imaging. Clin. Nucl. Med. 1993, 18: 448–449.

    Article  CAS  PubMed  Google Scholar 

  23. Kitapci M.T., Tastekin G., Turgut M., Caner B., Kars A., Barista I., Bekdik C. Preoperative localization of parathyroid carcinoma using Tc-99m MIBI. Clin. Nucl. Med. 1993, 18: 217–218.

    Article  CAS  PubMed  Google Scholar 

  24. O’Driscoll C.M., Baker F., Casey M.J., Duffy G.J. Localization of recurrent medullary thyroid carcinoma with technetium-99m-methoisobutylnitrile scintigraphy: a case report. J. Nucl. Med. 1991, 32: 2281–2283.

    PubMed  Google Scholar 

  25. Vattimo A., Bertelli P., Cintorino M., Burrino L., Volterrani D., Vella A., Lazzi S. HurthIe cell tumor dwelling in hot thyroid nodules: preoperative detection with technetium-99m-MIBI dual-phase scintigraphy. J. Nucl. Med. 1998, 39: 822–825.

    CAS  PubMed  Google Scholar 

  26. Stefanescu C., Meignan M., Rusu V. The value of scintigraphic imaging with 99mTc-MIBI for the diagnosis of gliomas. Rev. Med. Chir. Soc. Med. Nat. Iasi. 1995, 99: 99–107.

    CAS  PubMed  Google Scholar 

  27. Pui M.H., Du J.Q., Yueh T.C., Zeng S.Q. Imaging of nasopharyngeal carcinoma with Tc-99m MIBI. Clin. Nucl. Med. 1998, 23: 29–32.

    Article  CAS  PubMed  Google Scholar 

  28. Robinson D., Pinkas L., Mindlin L., Halperin N., Horn T. Technetium 99mTc-sestamibi bone scan in musculo- skeletal neoplasms. Harefuah 1997, 133: 509–514.

    CAS  PubMed  Google Scholar 

  29. Bom H.S., Kim Y.C., Song H.C., Min J.J., Kim J.Y., Park K.O. Technetium-99m-MIBI uptake in small cell lung cancer. J. Nucl. Med. 1998, 39: 91–94.

    CAS  PubMed  Google Scholar 

  30. Grunwald F., Menzel C., Bender H., Palmedo H., WilIkomm P., Ruhlmann J., Franckson T., Biersack H.J. Comparison of 18FDG-PET with 131iodine and 99mTc-sestamibi scintigraphy in differentiated thyroid cancer. Thyroid 1997, 7: 327–335.

    Article  CAS  PubMed  Google Scholar 

  31. Perez-Monte J.E., Brown M.L., Clarke M.R., Watson C.G., Carty S.E. Parathyroid hyperplasia, thymic carcinoid and pituitary adenoma detected with Technetium-99m-MIBI in MEN type I. J. Nucl. Med. 1997, 38: 1767–1769.

    CAS  PubMed  Google Scholar 

  32. Bernà LI. 99mTc-sestamibi en el diagnóstico de localización del hiperparatiroidismo. Rev. Esp. Med. Nucl. 1998, 17: 102–111.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Nuclear Medicine Department, Hospital Sant Pau, Sant Antoni Ma Claret, 167, 08025, Barcelona, Spain

    C. Marí, J. León, J. Farrerons, X. Matis-Guiu, A. Tembl, J. C. Martin, A. Flotats & Ll. Bernà

Authors
  1. C. Marí
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. León
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. Farrerons
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. X. Matis-Guiu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A. Tembl
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. J. C. Martin
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. A. Flotats
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ll. Bernà
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Marí, C., León, J., Farrerons, J. et al. Thymic carcinoid and parathyroid hyperplasia detection with 99mTc-MIBI men type 1. J Endocrinol Invest 22, 803–807 (1999). https://doi.org/10.1007/BF03343648

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03343648

Key-words

Search

Navigation