PDF(Pubmed)
Abstract：
BACKGROUND: Primary hyperparathyroidism, though relatively prevalent among endocrine disorders, affecting 1% of the general population, often presents diagnostic challenges. Given its potential to precipitate severe complications including nephrolithiasis and fractures, timely diagnosis, and effective management are crucial.
METHODS: A 38-year-old woman with hypercalcemia was referred to the Department of Nuclear Medicine for a Tc-99m MIBI scan.
METHODS: Tc-99m MIBI scan showed focal increased uptake in the left thyroid gland area, initially suggesting a parathyroid adenoma. Further examination using SPECT/CT revealed a nodular lesion within the left thyroid gland showing high Tc-99m MIBI uptake.
METHODS: Left thyroid lumpectomy confirmed the lesion as follicular thyroid carcinoma. On the second Tc-99m MIBI scan conducted after total thyroidectomy, a parathyroid adenoma was eventually detected in the right lower area, enabling the subsequent appropriate treatment, a right lower parathyroidectomy.
RESULTS: Thirteen days after the parathyroidectomy, serum levels of total calcium and parathyroid hormone returned to normal. Furthermore, bone mineral density evaluated using DEXA remained within the expected range for her age even after 14 months.
CONCLUSIONS: When interpreting the Tc-99m MIBI scan, it is essential to keep in mind that various tumors rich in mitochondria, such as thyroid carcinoma, could show a high uptake of Tc-99m MIBI.
METHODS: A 38-year-old woman with hypercalcemia was referred to the Department of Nuclear Medicine for a Tc-99m MIBI scan.
METHODS: Tc-99m MIBI scan showed focal increased uptake in the left thyroid gland area, initially suggesting a parathyroid adenoma. Further examination using SPECT/CT revealed a nodular lesion within the left thyroid gland showing high Tc-99m MIBI uptake.
METHODS: Left thyroid lumpectomy confirmed the lesion as follicular thyroid carcinoma. On the second Tc-99m MIBI scan conducted after total thyroidectomy, a parathyroid adenoma was eventually detected in the right lower area, enabling the subsequent appropriate treatment, a right lower parathyroidectomy.
RESULTS: Thirteen days after the parathyroidectomy, serum levels of total calcium and parathyroid hormone returned to normal. Furthermore, bone mineral density evaluated using DEXA remained within the expected range for her age even after 14 months.
CONCLUSIONS: When interpreting the Tc-99m MIBI scan, it is essential to keep in mind that various tumors rich in mitochondria, such as thyroid carcinoma, could show a high uptake of Tc-99m MIBI.
摘要：
背景：原发性甲状旁腺功能亢进，虽然在内分泌失调中相对普遍，影响了1%的总人口，经常提出诊断挑战。鉴于其可能导致严重的并发症，包括肾结石和骨折，及时诊断,有效的管理至关重要。
方法：一名患有高钙血症的38岁女性患者被转诊到核医学科进行Tc-99mMIBI扫描。
方法：Tc-99mMIBI扫描显示左侧甲状腺区域局部摄取增加，最初提示甲状旁腺腺瘤.使用SPECT/CT进行的进一步检查显示，左侧甲状腺内有结节性病变，显示高Tc-99mMIBI摄取。
方法：甲状腺左侧肿块切除证实病灶为甲状腺滤泡状癌。在甲状腺全切除术后进行的第二次Tc-99mMIBI扫描中，最终在右下部区域发现了甲状旁腺腺瘤，能够进行后续的适当治疗，右下甲状旁腺切除术.
结果：甲状旁腺切除术后13天，血清总钙和甲状旁腺激素水平恢复正常。此外，即使在14个月后,使用DEXA评估的骨矿物质密度仍保持在其年龄的预期范围内.
结论：解释Tc-99mMIBI扫描时，必须记住，富含线粒体的各种肿瘤，比如甲状腺癌，可以显示对Tc-99mMIBI的高摄取。
方法：一名患有高钙血症的38岁女性患者被转诊到核医学科进行Tc-99mMIBI扫描。
方法：Tc-99mMIBI扫描显示左侧甲状腺区域局部摄取增加，最初提示甲状旁腺腺瘤.使用SPECT/CT进行的进一步检查显示，左侧甲状腺内有结节性病变，显示高Tc-99mMIBI摄取。
方法：甲状腺左侧肿块切除证实病灶为甲状腺滤泡状癌。在甲状腺全切除术后进行的第二次Tc-99mMIBI扫描中，最终在右下部区域发现了甲状旁腺腺瘤，能够进行后续的适当治疗，右下甲状旁腺切除术.
结果：甲状旁腺切除术后13天，血清总钙和甲状旁腺激素水平恢复正常。此外，即使在14个月后,使用DEXA评估的骨矿物质密度仍保持在其年龄的预期范围内.
结论：解释Tc-99mMIBI扫描时，必须记住，富含线粒体的各种肿瘤，比如甲状腺癌，可以显示对Tc-99mMIBI的高摄取。
