Incidental Finding of Parathyroid Adenoma in a Patient with Breast Carcinoma Detected by PET/CT 18F -FDG Examination and Confirmed by 99 mTc -Terofosmin SPECT/CT

Authors

  • Albena Botushanova Department of Clinical Oncology https://orcid.org/0000-0003-2286-0936
  • Aleksandar Botushanov Department of Propaedeutics of Internal Diseases, Faculty of Medicine, Medical University of Plovdiv, Bulgaria https://orcid.org/0000-0002-0011-6738
  • Nikolay Botushanov Department of Endocrinology and Metabolic Diseases, Faculty of Medicine, Medical University of Plovdiv, Bulgaria https://orcid.org/0000-0002-4183-5341
  • Veselin Popov Department of Clinical Oncology, Faculty of Medicine, Medical University of Plovdiv, Bulgaria

DOI:

https://doi.org/10.3889/oamjms.2024.11918

Keywords:

Positron emission tomography–computed tomography;, 18F-Fluorodesoxyglucosae, Single-photon emission computed tomography/computed tomography, Parathyroid adenoma, Tetrofosmin

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.

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Author Biography

Nikolay Botushanov, Department of Endocrinology and Metabolic Diseases, Faculty of Medicine, Medical University of Plovdiv, Bulgaria

Department of Endocrinology and Metabolic diseases, Faculty of Medicine, Medical University, Plovdiv

Assistant professor

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Published

2024-06-15

How to Cite

1.
Botushanova A, Botushanov A, Botushanov N, Popov V. Incidental Finding of Parathyroid Adenoma in a Patient with Breast Carcinoma Detected by PET/CT 18F -FDG Examination and Confirmed by 99 mTc -Terofosmin SPECT/CT. Open Access Maced J Med Sci [Internet]. 2024 Jun. 15 [cited 2024 Jun. 17];12(2):335-8. Available from: https://oamjms.eu/index.php/mjms/article/view/11918

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Case Report in Internal Medicine

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