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Clinical Image
SPECT-CT and planar image of an ectopic mediastinal parathyroid adenoma
1 Consultant, Department of Medical Imaging, Division of Nuclear Medicine, Chi Mei Medical Center, Yongkang District, Tainan City, Taiwan, Republic of China
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Jih-Fang Hsieh
MD, 901, Chunghua Rd., Yongkang District, Tainan City 71004, Taiwan,
Republic of China
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Article ID: 101126Z01JH2020
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Hsieh JF. SPECT-CT and planar image of an ectopic mediastinal parathyroid adenoma. Int J Case Rep Images 2020;11:101126Z01JH2020.ABSTRACT
No Abstract
Keywords: Ectopic, Parathyroid adenoma, Single photon emission computed tomography-computed tomography
Case Report
A 50-year-old female was referred to our department for parathyroid scintigraphy due to incidental finding of hypercalcemia. Tc-99m methyliodobenzylguanidine (MIBI) post-tracer injection early planar image at 20 minutes (arrow in Figure 1A) and delayed image at 2 hours (arrow in Figure 1B) show persistent focus of radiotracer accumulation at the middle of medial left chest. This focus was localized by single photon emission computed tomography-computed tomography (SPECT-CT) (Figure 2) in the left superior anterior mediastinum which is suggestive of an ectopic parathyroid adenoma. The patient underwent video-assisted thoracoscopic surgery (VATS) and pathology confirmed an ectopic parathyroid adenoma.
Discussion
Anterior mediastinum is among one of the sites of an ectopic parathyroid adenoma. It has been reported in several studies that SPECT-CT offers the definite advantage of combined functional image and anatomic image in the accurate localization of a possible ectopic parathyroid gland. This case demonstrates the utility of SPECT-CT in optimal diagnosis in scintigraphy which combined anatomical and physiologic images [1],[2],[3],[4].
Conclusion
Single photon emission computed tomographycomputed tomography should be considered a standard in scintigraphy for optimal imaging of ectopic parathyroid gland.
REFERENCES
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Schillaci O, Danieli R, Manni C, Simonetti G. Is SPECT/CT with a hybrid camera useful to improve scintigraphic imaging interpretation? Nucl Med Commun 2004;25(7):705–10. [CrossRef]
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Krausz Y, Bettman L, Guralnik L, et al. Technetium-99m-MIBI SPECT/CT in primary hyperparathyroidism. World J Surg 2006;30(1):76–83. [CrossRef]
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SUPPORTING INFORMATION
Author Contributions
Jih-Fang Hsieh - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthor declares no conflict of interest.
Copyright© 2020 Jih-Fang Hsieh. 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.
