Parathyroid Adenoma Which Was Negative on Tc99m-MIBI Scintigraphy and Considered as Paratracheal Lymphadenopathy on Other Imaging Studies
Surgery is the most important treatment method in patients with primary hyperparathyroidism. Imaging studies for localization of parathyroid adenoma should be performed in all patients with hyperparathyroidism before surgical intervention. Tc99m scintigraphy, neck ultrasonography, and neck magnetic resonance imaging (MRI) are the most common imaging modalities used for the localization of a parathyroid adenoma. Atypical localization of parathyroid adenoma and multiple gland disease are the most important causes of persistent disease and redo surgery. We aimed to introduce a case of primary hyperparathyroidism with the presence of double adenoma. In our case, the second adenoma was mistakenly interpreted as lymphadenopathy in the preoperative imaging studies. The lesion has been confirmed as parathyroid adenoma in the final histopathologic examination.
Therefore, multiple or atypical localized parathyroid adenoma should be considered in all patients to be operated.
KeywordsParathyroid adenoma Double adenoma Neck MRI Tc99m-MIBI scintigraphy Lymphadenomegaly
We would like to thank Dr. Deniz Guzey and Cevher Akarsu for their valuable contribution to the surgical management of the patient.
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