Concomitant Hyperparathyroidism Due to Occult Parathyroid Adenoma Detected by Technetium-99m Sestamibi Single-photon Computed Tomography/Computerized Tomography in a Patient with Papillary Thyroid Carcinoma

Jiraporn Sriprapaporn, Pongthep Pisarnturakit, Tauangtham Anekpuritanang

Abstract

Although the occurrence of thyroid and parathyroid diseases is common, concomitant parathyroid adenoma and papillary thyroid carcinoma is rare. We report the case of a 77-year-old Thai woman who was diagnosed to have papillary thyroid carcinoma and postoperative hypercalcemia. The primary hyperparathyroidism was initially overlooked but was subsequently confirmed to be due to a single occult parathyroid adenoma demonstrated on technetium99m sestamibi (Tc-99m MIBI) parathyroid scintigraphy. Thus, preoperative evaluation of parathyroid disease should be performed if there is evidence of hypercalcemia prior to the thyroid surgery. Presurgical evaluation with Tc-99m MIBI parathyroid single-photon computed tomography/computerized tomography imaging has a definite role in localizing a hyperfunctioning parathyroid gland in the cases of primary hyperparathyroidism.

 Keywords

Hyperparathyroidism; parathyroid adenoma; parathyroid scintigraphy; SPECT/CT; thyroid cancer

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DOI: http://dx.doi.org/10.31584/jhsmr.2020751

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