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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
並列摘要
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 Takaaki Fujii1, Reina Yajima1, Hironori Tatsuki1, Hiroyuki Kuwano1 Affiliations: 1Department of General Surgical Science, Gunma University Graduate School of Medicine. Maebashi, Gunma, Japan. Corresponding Author: Takaaki Fujii, M.D., Ph.D., FACS, Department of General Surgical Science, Graduate School of Medicine, Gunma University, 3-39-22 Showa-machi, Maebashi, Gunma, Japan; E-mail: ftakaaki@med.gunma-u. ac.jp Received: 19 October 2015 Accepted: 23 November 2015 Published: 01 May 2016 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.
延伸閱讀
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