Falso negativo de la gammagrafía con 99mTc-sestamibi en un carcinoma paratiroideo con tumores pardos asociados. Aportaciones de la PET/TAC-18F-FDG

Chinchilla, A. Santiago; Font, C. Ramos; Fuentes, M.A. Muros de; Laínez, Martínez; Gerona, H. Palacios; Caballero, M. Moreno; Elvira, J.M. Llamas

doi:10.1016/j.remn.2010.08.006

Cited by 15 publications

(3 citation statements)

References 9 publications

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“…Considering the phenomenally raised parathormone levels, however, a hot nodule had been anticipated. The majority of cases of parathyroid cancer reported in the literature have described a dramatic lighting up of the lesion on the sestamibi scan, with a sensitivity of 85–100%, and specificity of 100% [ 13 ]. In our case, there was subtle tracer retention over upper and lower poles of right lobe of thyroid, with intensity of retention higher over the inferior pole.…”

Section: Discussionmentioning

confidence: 99%

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Case report: lady with bone pains for 5 years—parathyroid carcinoma

Rizwan

Jamal²,

Uzzaman

et al. 2018

BMC Res Notes

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BackgroundParathyroid cancer is a rare cause of primary hyperparathyroidism. It presents a diagnostic and therapeutic challenge that may not be recognized preoperatively, and is often not conclusively identified during the operation. We present the case of a lady with backache and hypercalcemia, but with inadequate work-up for her condition for several years.Case presentationA middle aged lady of Asian descent presented with backache. Initial work up revealed mild hypercalcemia, negative work up for multiple myeloma, negative sestamibi scan for parathyroid pathology. A phenomenally elevated parathormone (PTH) level—2105 pg/mL (16–87 pg/mL), and rising serum calcium, 15.1 mg/dL, (8.6–10.5 mg/dL), ordered years later prompted a repeat sestamibi scan and ultrasonography of neck. Based on these investigations, a diagnosis of primary hyperparathyroidism, with high suspicion of parathyroid cancer was made. The patient underwent surgical tumour resection, with subsequent histopathological confirmation of diagnosis.ConclusionIn the setting of hypercalcemia, PTH level assessment is a must. This helps to differentiate between the parathyroid dependant and independent causes of high serum calcium, thereby encouraging a comprehensive pathway to the work up of the cause of hypercalcemia. The parathyroid cancer is a very rare cause of hypercalcemia, which needs to be considered in the differentials of primary hyperparathyroidism, particularly in the setting of high PTH levels.Electronic supplementary materialThe online version of this article (10.1186/s13104-018-3711-0) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

“…A pin- hole collimator technique to obtain a magnified, higher resolution image focused on the neck, was not available at either Institute at that time. There has been a case reported in the literature of false negative scintigraphy in parathyroid carcinoma with associated brown tumours (term discussed below) [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Case report: lady with bone pains for 5 years—parathyroid carcinoma

Rizwan

Jamal²,

Uzzaman

et al. 2018

BMC Res Notes

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“…showed false negative of the scintigraphy with 99mTc-sestamibi in parathyroid carcinoma with associated brown tumors in their case report. [10]…”

Section: Discussionmentioning

confidence: 99%

Positron emission tomography/computed tomography imaging of brown tumors mimicking multiple skeletal metastases in patient with primary hyperparathyroidism

Sağer

Aliyev

Halaç

et al. 2012

Indian J Endocr Metab

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Brown tumors of bone are highly vascular, lytic bone lesions representing a reparative cellular process rather than a neoplastic process usually seen in patients with hyperparathyroidism. These tumors can behave aggressively and be destructive. We report a 49-year-old male patient who was admitted to our hospital with a long-term history of right shoulder and right hip pain. Multiple lytic and destructive bone lesions were found in X-ray graphy and CT images. These bone lesions mimicked multiple skeletal metastatic lesions and seemed to be those of the terminal stage of malignancy. PET scan was requested for the evaluation of FDG uptake of these lesions and to search the unknown primary tumor site. Positron emission tomography/computed tomography (PET/CT) images showed multiple hypermetabolic malignant or metastatic FDG avid bone lesions in skeletal system. However the biopsy results revealed no signs of malignancy and laboratory data showed elevated serum calcium, alkaline phosphatase, parathyroid hormone, low serum phosphate and parathyroid scintigraphy was performed. Adenoma in the left parathyroid gland was seen with Tc-99m MIBI parathyroid scintigraphy. Pathological results confirmed the diagnosis of parathyroid adenoma. Brown tumor is the potential cause of false-positive result in evaluation of a patient for unknown primary tumor or skeletal metastases with PET/CT imaging.

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