Abstract
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
Highlights
INTRODUCTIONPrimary hyperparathyroidism (PHPT) is a condition characterized by an excess secretion of parathyroid hormone by adenomatous or hyperplastic glands [1, 2]
A cystic lesion of the parathyroid gland causing hyperparathyroidism is an uncommon finding
We report a rare case of a patient with primary hyperparathyroidism (PHPT) with a functional parathyroid cyst in whom MIBI scintigraphy failed to detect a parathyroid tumor
Summary
Primary hyperparathyroidism (PHPT) is a condition characterized by an excess secretion of parathyroid hormone by adenomatous or hyperplastic glands [1, 2]. The eZ-SCOPE AN is designed to be used as a handheld, regional diagnostic imaging device, which is a new compact-type semiconductor gamma camera based on the use of a cadmium zinc telluride (CdZnTe) [18,19,20,21].We report here a rare case of a patients with a functioning parathyroid cyst in whom MIBI scintigraphy failed, but in whom a gamma camera could detect a parathyroid tumor signal intensity on T1-weighted images and high signal intensity on T2 images compared to the surrounding tissues (Figure 2). Neck ultrasonography and computed tomography (CT) scan revealed a right parathyroid tumor, but a Tc-99m MIBI scintigraphy examination failed to detect a parathyroid tumor He had been followed up because he was suffering from the hepatocellular carcinoma with liver cirrhosis. Our follow-up of the patient has remained uneventful, with no sign of recurrent disease
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