Elevated serum calcium and parathyroid hormone (PTH) values were determined in routine laboratory examinations of a 66-year-old female patient. Parathyroid scintigraphy (PS) and neck ultrasonography (USG) were performed for diagnosis of primary hyperparathyroidism.
PS revealed an ectopic parathyroid gland in the mediastinum. Fused SPECT/CT images were generated from PS SPECT and CT images using the co-registration software. Exact localization of ectopic parathyroid adenoma could be performed by fused SPECT/CT images. With the help of gamma probe, a soft tissue mass 1 cm in size was excised from anterior mediastinum in mediastinoscopy. Histopathological examinations were consistent with parathyroid adenoma. The patient was discharged from hospital after dropping of serum calcium value to the normal level.
In conclusion preoperative localization of abnormal ectopic parathyroid gland was done easily and more precisely by PS SPECT/CT in this case. And also, using gamma probe in parathyroidectomy helped to surgeons to find ectopic parathyroid adenoma quickly and precisely.
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