Article Text
Summary
We report the case of two patients with newly diagnosed primary hyperparathyroidism: a 40-year-old woman during pregnancy and a 60-year-old man with initial hypercalcaemic crisis. In the first case, a bilateral neck exploration with parathyroidectomy during the second trimester of pregnancy was unsuccessful and the patient remained hypercalcaemic. Postpartum imaging assessment with technetium (99mTc)-sestamibi scintigraphy could not supply conclusive diagnostic results. The use of 18F-fluorocholine (FCH) positron emission tomography (PET)/CT provided the accurate localisation of an ectopic parathyroid adenoma in the anterior mediastinum which was successfully resected by a thoracoscopic approach. In the second case, 99mTc-sestamibi scintigraphy was inconclusive as well and FCH-PET/CT localised an ectopic parathyroid adenoma in the mediastinum and thus bilateral neck exploration could be spared. Both patients had surgical cure of their disease.
- calcium and bone
- radiology
- cardiothoracic surgery
- otolaryngology / ent
Statistics from Altmetric.com
Footnotes
Contributors SF and MT both contributed equally as main authors of this manuscript. They were also responsible for the literature research. SF was the supervising author of the manuscript. KS and AL reviewed the manuscript and made their comments as specialists of nuclear medicine (KS) and as the operating cardiothoracic surgeon (AL). KS also provided figures 1 and 3 and AL provided figure 2.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.