scholarly journals A case report of successful identification of ectopic parathyroid adenomas with a sequence of selective parathyroid venous sampling and 4D-computed tomography in a patient with recurrent hyperparathyroidism

2020 ◽  
Vol 71 ◽  
pp. 183-186
Author(s):  
Onnicha Suntornlohanakul ◽  
Rattana Leelawattana
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Venous Sampling ◽  
Parathyroid Adenomas ◽  
4D Computed Tomography ◽  
Ectopic Parathyroid ◽  
Recurrent Hyperparathyroidism

Accuracy of Dual Phase Single-Photon Emission Computed Tomography/Computed Tomography in Primary Hyperparathyroidism: Correlation with Serum Parathyroid Hormone Levels

2016 ◽  
Vol 67 (2) ◽  
pp. 115-121 ◽  
Author(s):  
Wade Koberstein ◽  
Christopher Fung ◽  
Kristy Romaniuk ◽  
Jonathan T. Abele
Keyword(s):  
Computed Tomography ◽  
Primary Hyperparathyroidism ◽  
Predictive Value ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Dual Phase ◽  
Parathyroid Adenomas ◽  
Ectopic Parathyroid ◽  
Serum Pth

Purpose The objectives of this study were: 1) to determine the accuracy of dual-phase 99mTc -methoxyisobutylisonitrile (MIBI) with single-photon emission computed tomography/computed tomography (SPECT/CT) for the preoperative localization of parathyroid adenomas in the setting of primary hyperparathyroidism; 2) to determine the accuracy of localization for ectopic glands; and 3) to assess the relationship between accuracy and serum parathyroid hormone (PTH) levels. Methods Eighty-eight patients who underwent 99mTc-MIBI SPECT/CT imaging for primary hyperparathyroidism at our institution over a 27-month period were retrospectively assessed. The preoperative SPECT/CT results were compared to intraoperative findings (within 1 year of imaging). The relationship between serum PTH level (within 3 months) and SPECT/CT accuracy was then evaluated. Results Accuracy indices for the retrothyroid subgroup were sensitivity 86.7%, specificity 96.4%, positive predictive value 98.1%, negative predictive value 77.1%, and accuracy 89.8%. Accuracy indices for ectopic parathyroid adenomas were sensitivity 81.5%, specificity 100%, positive predictive value 100%, negative predictive value 92.4%, and accuracy 94.3%. For the overall group, SPECT/CT demonstrated a sensitivity of 85.1% and a PPV of 98.7%. SPECT/CT correctly identified the abnormal parathyroid gland in 60% of patients with a normal serum PTH (<6.9 pmol/L), 73% between 6.9-9.9 pmol/L, 86% between 10.0-14.9 pmol/L, 100% between 15.0-19.9 pmol/L, 88% between 20.0-24.5 pmol/L, and 100% of patients with a PTH greater than 25.0 pmol/L. Conclusions Dual-phase 99mTc- MIBI with SPECT/CT is an accurate and reliable means to correctly localize both retrothyroid and ectopic parathyroid adenomas for the purpose of surgical planning. The accuracy of SPECT/CT increases with increasing serum PTH levels.

scholarly journals Ectopic Parathyroid Adenoma in Piriform Sinus: Case Report and Review of the Literature

2019 ◽  
Vol 98 (1) ◽  
pp. 14-17
Author(s):  
Michael J. Connolly ◽  
Dorothy Lazinski ◽  
Katherine A. Aoki ◽  
Laurie McLean ◽  
Carlos Torres ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Parathyroid Adenoma ◽  
Emission Computed Tomography ◽  
Piriform Sinus ◽  
Ectopic Parathyroid Adenoma ◽  
Sestamibi Scintigraphy ◽  
Parathyroid Adenomas ◽  
Ectopic Parathyroid ◽  
The Right ◽  
Increased Activity

During routine blood work, a 53-year-old female patient was noted to have asymptomatic hypercalcemia and subsequently found to have hyperparathyroidism. Localization studies for a suspected parathyroid adenoma included 99mTc Sestamibi scintigraphy, Single Photon Emission Computed Tomography (SPECT)/computed tomography (CT) study, and ultrasound of the neck, which were initially read as negative for parathyroid adenoma. A contrast-enhanced CT scan of the neck was performed to locate the suspected parathyroid adenoma and demonstrated a soft tissue lesion within the right piriform sinus. Flexible fiber optic nasolaryngoscopy revealed a submucosal lesion in the right piriform sinus. Following these findings, the initial 99mTc Sestamibi scintigraphy and SPECT/CT were reviewed with confirmation of a focal area of increased activity superior to the right thyroid lobe, corresponding to a nodule in the right piriform sinus that demonstrated increased activity on SPECT/CT. The patient was brought to the operating room for surgical management where a laryngoscope and operating microscope were utilized. The encapsulated lesion was dissected and excised in total. The parathyroid hormone and ionized calcium levels normalized postoperatively. Pathology confirmed a parathyroid adenoma. Parathyroid adenomas are the most common cause of primary hyperparathyroidism. Sixteen percent of parathyroid adenomas can be situated in an ectopic location. Ectopic parathyroid adenomas in the piriform sinus are rare with only a few previously documented cases. We document a rare case of ectopic parathyroid adenoma in the piriform sinus overlooked on initial imaging studies. These lesions can be challenging to localize, however, an understanding of embryology, close scrutiny of possible ectopic locations, and the application of complementary imaging techniques may prove useful for surgeons and clinicians.

Transient Prealbumin- Associated Hyperthyroxinemia in TSH-Producing Pituitary Adenoma

1990 ◽  
Vol 29 (01) ◽  
pp. 40-43 ◽  
Author(s):  
W. Langsteger ◽  
P. Költringer ◽  
P. Wakonig ◽  
B. Eber ◽  
M. Mokry ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Pituitary Adenoma ◽  
Thyroid Hormones ◽  
Protein Binding ◽  
Alpha Subunit ◽  
Normal Range ◽  
Thyroxine Binding Globulin ◽  
Free Thyroid Hormones ◽  
Transmission Computed Tomography

This case report describes a 38-year-old male who was hospitalized for further clarification of clinically mild hyperthyroidism. His increased total hormone levels, the elevated free thyroid hormones and the elevated basal TSH with blunted response to TRH strongly suggested a pituitary adenoma with inappropriate TSH incretion. Transmission computed tomography showed an intrasellar expansion, 16 mm in diameter. The neoplastic TSH production was confirmed by an elevated alpha-subunit and a raised molar alpha-sub/ATSH ratio. However, T4 distribution on prealbumin (PA, TTR), albumin (A) and thyroxine binding globulin (TBG) showed a clearly increased binding to PA (39%), indicating additional prealbumin-associated hyperthyroxinemia. The absolute values of PA, A and TBG were within the normal range. After removal of the TSH-producing adenoma, basal TSH, the free thyroid hormones and T4 binding to prealbumin returned to normal. Therefore, the prealbumin-associated hyperthyroxinemia had to be interpreted as a transitory phenomenon related to secondary hyperthyroidism (T4 shift from thyroxine binding globulin to prealbumin) rather than a genetically conditioned anomaly of protein binding.

Coronary Artery Fistula Detected by 64-Slice Multidetector Computed Tomography: Case Report

2010 ◽  
Vol 13 (3) ◽  
pp. E198-E199
Author(s):  
Yi-Chang Lin ◽  
Yi-Ting Tsai ◽  
Chih-Yuan Lin ◽  
Chung-Yi Lee ◽  
Gou-Jieng Hong ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Coronary Artery ◽  
Multidetector Computed Tomography ◽  
Coronary Artery Fistula

Birt-Hogg-Dubé Syndrome: A Case Report Describing Sonographic Evaluation of Salivary Gland Oncocytomas

2019 ◽  
Vol 2 ◽  
pp. 5
Author(s):  
Kevin Kapcio ◽  
Kamila Skalski ◽  
Vikram Dogra
Keyword(s):  
Salivary Gland ◽  
Case Report ◽  
Renal Cell ◽  
Autosomal Dominant ◽  
Colonic Polyps ◽  
Sonographic Evaluation ◽  
Parathyroid Adenomas ◽  
Pulmonary Cysts ◽  
Renal Screening ◽  
Bhd Syndrome

Birt-Hogg-Dubé (BHD) syndrome is a rare hereditary disorder associated with autosomal dominant hereditary epithelial carcinomas, in which patients have an increased incidence of renal cell carcinomas, scattered hamartomas, pulmonary cysts, and spontaneous pneumothoraces. Other less common findings include lipomas, parathyroid adenomas, salivary gland tumors, and colonic polyps/tumors. Early diagnosis of BHD can help establish renal screening and reduce mortality by early detection and more effective treatment of renal cell carcinoma. This case report describes the sonographic features of salivary gland oncocytomas found in a patient with BHD.

OBTURATOR HERNIA: A CASE REPORT

2016 ◽  
pp. 106-109
Author(s):  
Hoang Minh Thi Nguyen ◽  
Huu Tri Nguyen ◽  
Thanh Thao Nguyen
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Intestinal Obstruction ◽  
Key Words ◽  
Clinical Manifestation ◽  
Elderly Women ◽  
Obturator Hernia ◽  
Abdominal Hernia ◽  
Mechanical Obstruction

Obturator hernia is a rare pelvic hernia which accounts for 1% of all abdominal hernia. Clinical manifestation is ussually unspecific. Obturator hernia is often diagnosed by computed tomography or ultrasound. We present a case of obturator hernia in an elderly women who was successfully diagnosed and treated at Hue Univeristy of Medicine and Pharmacy. Key words: obturator hernia, mechanical obstruction, intestinal obstruction, Richter obturator hernia, strangulation

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