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Use of sestamibi scan and radio-guided para thyroidectomy in persistent hyperparathyroidism

Author(s): Asieh Sadat Fattahi Masoum | Ali Reza Tavassoli | Ramin Sadeghi | Kamran Adhami

Journal: Iranian Journal of Nuclear Medicine
ISSN 1681-2824

Volume: 18;
Issue: Suppl 1;
Start page: 106;
Date: 2010;
Original page

Keywords: Hyperparathyroidism | Sestamibi | Scan

We report a woman with severe hypercalcemia and adenoma of parathyroid that intra operative use of radiotracer and Sestamibi scan helped finding missed tumor in the second operation and we reviewed some literatures. Case presentation: a 42 years old woman with bone paint, fever and neurologic problems from months ago was referred to us. Severe hypercalcemia and increase parathyroid hormone with radiologic signs (salt and paper in skull imaging) showed primary hyperparathyroidism. Ultrasound reports a mass near lower lobe of left thyroid. In first operation 2×3cm mass at this place was removed but calcium was elevated after operation. Then Sestamibi scan showed increase uptake in left side again. Before the second operation radioisotope was injected and a hand-held gamma probe was used intraoperative. It identified the enlarged gland at the left side with 3 times more radioactivity counts. Frozen section and permanent pathology showed adenoma of parathyroid. Sestamibi scan and radio-guided parathyroidectomy can be helpful in finding missed or ectopic parathyroid adenoma after first operation.
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