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Case Report
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| A parathyroid cyst associated with an adenoma causing primary hyperparathyroidism (PHPT): Gamma camera localization for case with MIBI scan-negative PHPT | ||||||
| Takaaki Fujii1, Reina Yajima1, Hironori Tatsuki1, Hiroyuki Kuwano1 | ||||||
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1Department of General Surgical Science, Gunma University Graduate School of Medicine. Maebashi, Gunma, Japan.
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| Fujii T, Yajima R, Tatsuki H, Kuwano H. A parathyroid cyst associated with an adenoma causing primary hyperparathyroidism (PHPT): Gamma camera localization for case with MIBI scan-negative PHPT. Int J Case Rep Imag 2016;7(5):318–322. |
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Abstract
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Introduction:
A cystic lesion of the parathyroid gland causing hyperparathyroidism is an uncommon finding. Tc-99m MIBI scintigraphy is a useful preoperative diagnostic tool in primary hyperparathyroidism (PHPT). We report a rare case of a patient with PHPT with a functional parathyroid cyst in whom MIBI scintigraphy failed to detect a parathyroid tumor.
Case Report: A 70-year-old Japanese man was referred to our hospital for the examination and treatment of hypercalcemia and a high level of intact PTH. Computed tomography scan, Magnetic resonance imaging scan, and ultrasonography of his neck showed a cystic mass in the lower right side of the neck measuring approximately 3.0×2.0 cm, whereas MIBI scintigraphy failed to detect a parathyroid tumor. Resection of the right cystic mass was performed. Scintigraphy images of the neck were acquired by an eZ-SCOPE hand-held gamma camera before the skin incision, and ex vivo imaging of the specimen was performed, which was useful for the navigation surgery and minimally invasive parathyroidectomy. Histopathology showed a parathyroid adenoma with prominent cystic degeneration. Conclusion: False-negative diagnostic results have been reported in cystic parathyroid adenomas. In cases of cystic hyperfunctioning scan-negative parathyroid tumors, the eZ-SCOPE may be useful for the localization and navigation surgery of primary hyperparathyroidism due to a cystic parathyroid tumor. | |
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Keywords:
Gamma camera, Navigation surgery, Primary hyperparathyroidism, Parathyroid cyst, Sestamibi scintigraphy
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Author Contributions
Takaaki Fujii – Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Reina Yajima – Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Hirnori Tatsuki – Substantial contributions to conception and design, Drafting the article, Final approval of the version to be published Hiroyuki Kuwano – Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© 2016 Takaaki Fujii et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
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