Incidental Finding of Parathyroid Adenoma in a Patient with Breast Carcinoma Detected by PET/CT 18F -FDG Examination and Confirmed by 99 mTc -Terofosmin SPECT/CT
, , y | 18 jun 2024
Publicado en línea: 18 jun 2024
Páginas: 335 - 338
Recibido: 20 abr 2024
Aceptado: 20 may 2024
DOI: https://doi.org/10.3889/oamjms.2024.11918
Palabras clave
© 2024 Albena Botushanova et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License.
BACKGROUND
Primary hyperparathyroidism (PHPT) is due to the overproduction of PTH by one or more abnormally altered parathyroid glands and leads to the development of hypercalcemia.
CASE PRESENTATION
We present a case of a 69-year-old female patient who was diagnosed with carcinoma of the right mammary gland in 2010. She underwent surgical treatment (right sided mammectomy) and follow-up hormone therapy with Letrozole until cancer remission in 2020. The patient was sent for a positron emission tomography-computed tomography (PET/CT) scan for restaging in May 2022. The patient underwent a whole-body PET/CT 18F-Fluorodesoxyglucosae (18F-FDG) examination on a “SIEMENS” hybrid PET/CT device, model “Biograph mCT64.” During the processing of the hybrid PET/CT images, a rounded lesion suspicious for a parathyroid adenoma of the lower right parathyroid gland was visualized with a slightly increased metabolic activity of SUVmax-2.91. The neck ultrasound revealed a solid, hypoechoic, rounded formation with peripheral blood supply suspicious for a lower right parathyroid adenoma. Blood tests revealed primary hyperparathyroidism osteoporosis of the proximal femur. To diagnostic clarification of the area caudal to the right lobe of the thyroid gland, after 1 month, a single isotope two-phase scintigraphy with 99 mTc-tetrofosmin combined with an early single-photon emission CT (SPECT/CT) technique was performed on a SPECT/CT gamma camera “Siemens,” model “Symbia Intevo 6.” In the early phase (20 min.) and on the early SPECT/CT images, a hyperfixing zone accumulating the radiomarker, suspicious for a parathyroid adenoma, was visualized under the right lobe of the thyroid gland. The patient underwent surgery, during which a parathyroid adenoma was histologically proven.
CONCLUSION
This case shows that PET/CT 18F-FDG examination can be useful in discovering parathyroid adenomas.