Abstract
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.
Publisher
Scientific Foundation SPIROSKI