Nuclear Medicine Cases

  • Qaisar Hussain Siraj


A 23-year-old girl with hyperparathyroidism was referred for parathyroid scintigraphy in 1986 following a previously failed parathyroidectomy. The patient had raised serum calcium and parathormone. On examination, there was a palpable nodule in the left lobe of the thyroid.


  1. 1.
    Prasad KK, Agarwal G, Krishnani N. Water-clear cell adenoma of the parathyroid gland: a rare entity. Indian J Pathol Microbiol. 2004;47(1):39–40.PubMedPubMedCentralGoogle Scholar
  2. 2.
    Weymouth MD, Serpell JW, Chambers D. Palpable parathyroid adenomas presenting as clinical solitary thyroid nodules and cytologically as follicular thyroid neoplasms. ANZ J Surg. 2003;73:36–9.PubMedCrossRefPubMedCentralGoogle Scholar
  3. 3.
    Arnstein AR, Rosenberg IK, Belamaric J, et al. Palpable calcified parathyroid gland in primary chief-cell hyperplasia. N Engl J Med. 1971;285:1365–6.PubMedCrossRefPubMedCentralGoogle Scholar
  4. 4.
    Woolfson AM, Fleming JA, Stewart JS. A palpable parathyroid tumour in a patient with osteogenesis imperfecta. Proc R Soc Med. 1975;68:61–2.PubMedPubMedCentralGoogle Scholar
  5. 5.
    Bégueret H, Belleannée G, Dubrez J, Trouette H, Parrens M, Velly JF, de Mascarel A. Clear cell adenoma of the parathyroid gland: a rare and misleading lesion. Ann Pathol. 1999;19(4):316–9.PubMedPubMedCentralGoogle Scholar
  6. 6.
    Kanda K, Okada Y, Tanikawa T, Morita E, Tsurudome Y, Konishi T, et al. A rare case of primary hyperparathyroidism with clear cell adenoma. Endocr J. 2004;51(2):207–12.PubMedCrossRefPubMedCentralGoogle Scholar
  7. 7.
    Henry J-F, Lacobone M. Ectopic parathyroid glands. In: Licata AA, Lerma EV, editors. Diseases of the parathyroid glands. New York, NY: Springer Science+Business Media; 2012.Google Scholar
  8. 8.
    Akerstrom G, Malmaeus J, Bergstrom R. Surgical anatomy of human parathyroid glands. Surgery. 1984;95:14–21.PubMedPubMedCentralGoogle Scholar
  9. 9.
    Roses DF, Karp NS, Sudarsky LA, et al. Primary hyperparathyroidism associated with two enlarged parathyroid glands. Arch Surg. 1989;124:1261–5.PubMedCrossRefPubMedCentralGoogle Scholar
  10. 10.
    Attie JN, Bock G, Auguste LJ. Multiple parathyroid adenomas: report of thirty-three cases. Surgery. 1990;108:1014–20.PubMedPubMedCentralGoogle Scholar
  11. 11.
    Tezelman S, Shen W, Shaver JK, Siperstein AE, Duh Q-Y, Klein H, Clark OH. Double Parathyroid adenomas clinical and biochemical characteristics before and after parathyroidectomy. Ann Surg. 1993;218(3):300–9.PubMedPubMedCentralCrossRefGoogle Scholar
  12. 12.
    Taillefer R, Boucher Y, Potvin C, et al. Detection and localization of parathyroid adenomas in patients with hyperparathyroidism using a single radionuclide imaging procedure with technetium-99m-sestamibi (double-phase study). J Nucl Med. 1992;33:1801.PubMedPubMedCentralGoogle Scholar
  13. 13.
    Osmanagouglu K, Schelstraete K, Lippens M, et al. Visualization of a parathyroid adenoma with Tc-99m MIBI in a case with iodine saturation and impaired thallium uptake. Clin Nucl Med. 1993;18:214.CrossRefGoogle Scholar
  14. 14.
    Wheeler MH. Clinical anatomy, developmental aberrations and endocrinology. In: Arora A, Tolley N, Tuttle M, editors. A practical manual of thyroid and parathyroid disease. London: Wiley-Blackwell; 2010. p. 184–5.Google Scholar
  15. 15.
    Gupta Y, Ahmed R, Happerfield L, Pinder SE, Balan KK, Wishart GC. P-glycoprotein expression is associated with sestamibi washout in primary hyperparathyroidism. Br J Surg. 2007;94(12):1491–5.PubMedCrossRefPubMedCentralGoogle Scholar
  16. 16.
    Sun SS, Shiau YC, Lin CC, et al. Correlation between P-glycoprotein (P-gp) expression in parathyroid and Tc-99m MIBI parathyroid image findings. Nucl Med Biol. 2001;28:929–33.PubMedCrossRefPubMedCentralGoogle Scholar
  17. 17.
    Seki K, Hashimoto K, Hisada T, Maeda M, Satoh T, Uehara Y, et al. A patient with classic severe primary hyperparathyroidism in whom both Tc-99m MIBI scintigraphy and FDG-PET failed to detect the parathyroid tumor. Intern Med. 2004;43:816–23.PubMedCrossRefPubMedCentralGoogle Scholar
  18. 18.
    Mehta NY, Ruda JM, Kapadia S, Boyer PJ, Hollenbeak CS, StackJr BC. Relationship of technetium Tc99m sestamibi scans to histopathological features of hyperfunctioning parathyroid tissue. Arch Otolaryngol Head Neck Surg. 2005;131:493–8.PubMedCrossRefPubMedCentralGoogle Scholar
  19. 19.
    Philippon M, Guerin C, Taieb D, Vaillant J, Morange I, Brue T, Conte-Devolx B, Henry JF, Slotema E, Sebag F, Castinetti F. Bilateral neck exploration in patients with primary hyperparathyroidism and discordant imaging results: a single-centre study. Eur J Endocrinol. 2014;170:719–25.PubMedCrossRefPubMedCentralGoogle Scholar
  20. 20.
    Mahoney EJ, Monchik JM, Donatini G, De Lellis R. Life-threatening hypercalcemia from a hepatocellular carcinoma secreting intact parathyroid hormone: localization by sestamibi single-photon emission computed tomographic imaging. Endocr Pract. 2006;12(3):302–6.PubMedCrossRefPubMedCentralGoogle Scholar
  21. 21.
    Ohi S, Niimi S, Okada N, Yamada K, Tachibana T, Hashimoto H, Nakajima M, Yasuda M, Tanaka T, Sato K, Ishikawa H. Establishment and characterization of a human ovarian small cell carcinoma, hypercalcemic type, cell line (OS-1) secreting PTH, PthrP and ACTH--special reference to the susceptibility of anti-cancer drugs. Hum Cell. 2004;17(4):203–9.PubMedCrossRefPubMedCentralGoogle Scholar
  22. 22.
    Kar P, Meeking D. A probable PTH- secreting metastatic breast carcinoma. 197th Meeting of the Society for Endocrinology, London, UK. Endoc Abs. 2006;12:64.Google Scholar
  23. 23.
    Thompson NW, Eckhauser FE, Harness JK. The anatomy of primary hyperparathyroidism. Surgery. 1982;92:814–21.PubMedPubMedCentralGoogle Scholar
  24. 24.
    Levin KE, Clark OH. The reasons for failure in parathyroid operations. Arch Surg. 1989;124:911–4.PubMedCrossRefPubMedCentralGoogle Scholar
  25. 25.
    Summers GW. Parathyroid update: a review of 220 cases. Ear Nose Throat J. 1996;75:434–9.PubMedCrossRefPubMedCentralGoogle Scholar
  26. 26.
    Mariani G, Mazzeo S, Rubello D, Bartolozzi C. Preoperative localization of abnormal parathyroid glands. In: Bilezikian JP, Marcus R, Levine MA, Marcocci C, Silverberg SJ, Potts JT, editors. The parathyroids: basic and clinical concepts. 3rd ed. London: Academic Press; 2014.Google Scholar
  27. 27.
    Wheeler MH, Williams ED, Wade JSH. The hyperfunctioning intrathyroidal parathyroid gland: a potential pitfall in parathyroid surgery. World J Surg. 1987;11:110–4.PubMedCrossRefPubMedCentralGoogle Scholar
  28. 28.
    Sheffield EA. An approach to common pathological conditions in the parathyroid glands. CPD Cell Pathol. 2002;4:135–8.Google Scholar
  29. 29.
    Rink T, Schroth HJ, Holle LH, Garth H. Limited sensitivity of parathyroid imaging with (99m)Tc-sestamibi (123)I subtraction in an endemic goiter area. J Nucl Med. 2002;43(9):1175–80.PubMedPubMedCentralGoogle Scholar
  30. 30.
    Goljan EF. Rapid review of pathology. 4th ed. Philadelphia, PA: Saunders; 2014.Google Scholar
  31. 31.
    Mallet E, Castanet M. Primary hyperparathyroidism in neonates and children [1]. In: Licata AA, Lerma EV, editors. Diseases of the parathyroid glands. New York, NY: Springer Science+Business Media; 2012.Google Scholar
  32. 32.
    Sagliker Y, Acharya V, Ling Z, et al. International study on Sagliker syndrome and uglifying human face appearance in severe and late secondary hyperparathyroidism in chronic kidney disease patients. J Ren Nutr. 2008;18(1):114–7.PubMedCrossRefPubMedCentralGoogle Scholar
  33. 33.
    Wittenberg A. The Rugger Jersey spine sign. Radiology. 2004;230(2):491–2.PubMedCrossRefPubMedCentralGoogle Scholar
  34. 34.
    Ming-Che C, Shih-Chuan C, Wan-YuLin T. Dual-phase 99mTc-MIBI parathyroid imaging reveals synchronous parathyroid adenoma and papillary thyroid carcinoma: a case report. Kaohsiung J Med Sci. 2008;24(10):542–7.CrossRefGoogle Scholar
  35. 35.
    Kalinin AP, Pavlov AV, Alexandrov YK, Kotova IV, Patrunov YN, Pamputis SN. The parathyroid glands imaging and surgery. Berlin: Springer; 2013.CrossRefGoogle Scholar
  36. 36.
    Mezosi E, Bajnok L, Gyory F, Varga J, Sztojka I, Szabo J, Galuska L, Leovey A, Kakuk G, Nagy. The role of technetium-99m methoxyisobutylisonitrile scintigraphy in the differential diagnosis of cold thyroid nodules. Eur J Nucl Med. 1999;26(8):798–803.PubMedCrossRefPubMedCentralGoogle Scholar
  37. 37.
    Rubello D, Toniato A, Pelizzo MR, Casara D. Papillary thyroid carcinoma associated with parathyroid adenoma detected by pertechnetate-MIBI subtraction scintigraphy. Clin Nucl Med. 2000;25(11):898–900.PubMedCrossRefPubMedCentralGoogle Scholar
  38. 38.
    Sekine O, Hozumi Y, Takemoto N, Kiyozaki H, Yamada S, Konishi F. Parathyroid adenoma without hyperparathyroidism. Jpn J Clin Oncol. 2004;34(3):155–8.PubMedCrossRefPubMedCentralGoogle Scholar
  39. 39.
    Akerstrom G, Rudberg C, Grimelius L, Bergstrom R, Johansson H, Ljunghall S, et al. Histologic parathyroid abnormalities in an autopsy series. Hum Pathol. 1986;17:520–7.PubMedCrossRefPubMedCentralGoogle Scholar
  40. 40.
    Silverberg SJ, Clarke BL, Peacock M, Bandeira F, Boutroy S, Cusano NE, Dempster D, Lewiecki EM, Liu JM, Minisola S, Rejnmark L, Silva BC, Walker MD, Bilezikian JP. Current issues in the presentation of asymptomatic primary hyperparathyroidism: proceedings of the Fourth International Workshop. J Clin Endocrinol Metab. 2014;99:3580–94.PubMedPubMedCentralCrossRefGoogle Scholar
  41. 41.
    Anne-Sophie P, Salima B, Bruno K, Simona B, Marie-Cécile N, Luc M, Julian D, Thierry VB. Unusual parathyroid adenoma avid for both Tc-99m sestamibi and I-123 iodine. Clin Nucl Med. 2010;35(11):888–90.CrossRefGoogle Scholar
  42. 42.
    Kiratli PO, Peksoy I, Erbaş B, Gedikoğlu G, Karabulut N. Technetium-99m pertechnetate uptake in ectopic parathyroid adenoma. Ann Nucl Med. 1999;13(2):113–5.PubMedCrossRefPubMedCentralGoogle Scholar
  43. 43.
    Palestro CJ, Tomas MB, Tronco GG. Radionuclide imaging of the parathyroid glands. Semin Nucl Med. 2005;35(4):266–76.PubMedCrossRefPubMedCentralGoogle Scholar
  44. 44.
    Bronner M, Li VV. Oxyphilic (Askanazy/Hürthle cell) tumors of the thyroid: microscopic features predict biological behaviour. Surg Pathol. 1988;1:137–50.Google Scholar
  45. 45.
    Carcangiu ML, Bianchi S, Savino D, Voynick IM, Rosai J. Follicular Hürthle cell tumors of the thyroid gland. Cancer. 1991;68:1944–53.PubMedCrossRefPubMedCentralGoogle Scholar
  46. 46.
    McIvor NP, Freeman JL, Rosen, Bedard YC. Value of fine-needle aspiration in the diagnosis of Hurthle cell neoplasms. Head Neck. 1993;15:335–41.PubMedCrossRefPubMedCentralGoogle Scholar
  47. 47.
    Boi F, Lai ML, Deias C, Piga M, Serra A, Uccheddu A, Faa G, Mariotti S. The usefulness of 99mTc-SestaMIBI scan in the diagnostic evaluation of thyroid nodules with oncocytic cytology. Eur J Endocrinol. 2003;149:493–8.PubMedCrossRefPubMedCentralGoogle Scholar
  48. 48.
    Wermers RA, Khosla S, Atkinson EJ, et al. The rise and fall of primary hyperparathyroidism: a population-based study in Rochester, Minnesota, 1965–1992. Ann Intern Med. 1997;126:433.PubMedCrossRefPubMedCentralGoogle Scholar
  49. 49.
    Khan A, Bilezikian J. Primary hyperparathyroidism: pathophysiology and impact on bone. Can Med Assoc J. 2000;163:184.Google Scholar
  50. 50.
    Cannon J, Lew JI, Solorzano CC. Parathyroidectomy for hyperparathyroid crisis: 40 years experience and long term outcomes. Surgery. 2010;148:807–13.PubMedCrossRefPubMedCentralGoogle Scholar
  51. 51.
    Koss WGM, Brown MR, Balfour JF. A False-positive localization of a parathyroid adenoma with technetium Tc 99m sestamibi scan secondary to a thyroid follicular carcinoma. Arch Surg. 1996;131(2):216–7.PubMedCrossRefPubMedCentralGoogle Scholar
  52. 52.
    Strewler GJ, Budayr AA, Clark OH, Nissenson RA. Production of parathyroid hormone by a malignant nonparathyroid tumor in a hypercalcemic patient. J Clin Endocrinol Metab. 1993;76:1373–5.PubMedPubMedCentralGoogle Scholar
  53. 53.
    Lehwald N, Cupisti K, Krausch M, Ahrazoglu M, Raffel A, Knoefel WT. Coincidence of primary hyperparathyroidism and nonmedullary thyroid carcinoma. Horm Metab Res. 2013;45(9):660–3.PubMedCrossRefPubMedCentralGoogle Scholar
  54. 54.
    Vysetti S, Sridhar P, Theckedath B, Gilden JL, Morawiecki P. Synchronous papillary thyroid carcinoma and primary hyperparathyroidism: diagnosis and management issues. Hosp Pract. 2012;40(4):16–9.CrossRefGoogle Scholar
  55. 55.
    Palmer M, Adami HO, Krusemo UB, Ljunghall S. Increased risk of malignant diseases after surgery for primary hyperparathyroidism - a nationwide cohort study. Am J Epidemiol. 1988;127:1031–40.PubMedCrossRefPubMedCentralGoogle Scholar
  56. 56.
    Ogard CG, Engholm G, Almdal TP, Vestergaard H. Increased mortality in patients hospitalised with primary hyperparathyroidism during the period 1977–1993 in Denmark. World J Surg. 2004;28:108–11.PubMedCrossRefPubMedCentralGoogle Scholar
  57. 57.
    Arnold A, Brown MF, Urena P, Gaz RD, Sarfati E, Drueke TB. Monoclonality of parathyroid tumors in chronic renal failure and in primary parathyroid hyperplasia. J Clin Invest. 1995;95:2047–53.PubMedPubMedCentralCrossRefGoogle Scholar
  58. 58.
    Nygren P, Larsson R, Johansson H, Ljunghall S, Rastad J, Akerstrom G. 1,25(OH)2D3 inhibits hormone secretion and proliferation but not functional dedifferentiation of cultured bovine parathyroid cells. Calcif Tissue Int. 1988;43:213–8.PubMedCrossRefPubMedCentralGoogle Scholar
  59. 59.
    Kalinin AP, Pavlov AV, Alexandrov YK, Kotova IV, et al. The parathyroid glands. Imaging and surgery. Berlin: Springer; 2013.CrossRefGoogle Scholar
  60. 60.
    Parfitt AM. The hyperparathyroidism of chronic renal failure: a disorder of growth. Kidney Int. 1997;52:3–9.PubMedCrossRefPubMedCentralGoogle Scholar
  61. 61.
    Slatopolsky E, Delmez JA. Pathogenesis of secondary hyperparathyroidism. Am J Kidney Dis. 1994;23:229–36.PubMedCrossRefPubMedCentralGoogle Scholar
  62. 62.
    Huppert BJ, Reading CC. Parathyroid sonography: imaging and intervention. J Clin Ultrasound. 2007;35:144–55.PubMedCrossRefPubMedCentralGoogle Scholar
  63. 63.
    Gartner LP, Hiatt JL. Color textbook of histology. 3rd ed. Philadelphia, PA: W.B. Saunders; 2006. p. 314–6.Google Scholar
  64. 64.
    Berkovitz BK. Neck and upper aero-digestive tract. In: Standring S, Ellis H, Healy JC, Johnson D, Williams A, Collins P, et al., editors. Gray’s anatomy: the anatomical basis of clinical practice. 39th ed. London: Elsevier Churchill Livingstone; 2005. p. 564–5.Google Scholar
  65. 65.
    Mahbub S, Ara S, Alim A, Nurunnabi ASM, Ahmed R, Begum M. Different shapes of the human parathyroid glands – a postmortem study. J Dhaka Med Coll. 2009;18(1):44–6.CrossRefGoogle Scholar
  66. 66.
    Akerström G, Malmaeus J, Bergström R. Surgical anatomy of human parathyroid glands. Surgery. 1984;95:14–21.PubMedPubMedCentralGoogle Scholar
  67. 67.
    Brown EM. Control of parathyroid hormone secretion by its key physiological regulators. In: Bilezikian JP, Marcus R, Levine MA, Marcocci C, Silverberg SJ, Potts JT, editors. The parathyroids: basic and clinical concepts. 3rd ed. London: Elsevier; 2014.Google Scholar
  68. 68.
    Licata AA, Lerma EV, editors. Diseases of the parathyroid glands. New York, NY: Springer Science+Business Media; 2012.Google Scholar
  69. 69.
    Kandil E, Tufaro AP, Carson KA, Lin F, Somervell H, Farrag T, et al. Correlation of plasma 25-hydroxyvitamin D levels with severity of primary hyperparathyroidism and likelihood of parathyroid adenoma localization on sestamibi scan. Arch Otolaryngol Head Neck Surg. 2008;134(10):1071–5.PubMedCrossRefPubMedCentralGoogle Scholar
  70. 70.
    Silverberg SJ, Bilezikian JP. Asymptomatic primary hyperparathyroidism. In: Bilezikian JP, Marcus R, Levine MA, Marcocci C, Silverberg SJ, Potts JT, editors. The parathyroids: basic and clinical concepts. 3rd ed. London: Elsevier; 2014.Google Scholar
  71. 71.
    Björkman M, Sorva A, Tilvis R. Responses of parathyroid hormone to vitamin D supplementation: a systematic review of clinical trials. Arch Gerontol Geriatr. 2009;48:160–6.PubMedCrossRefPubMedCentralGoogle Scholar
  72. 72.
    Erbil Y, Kapran Y, Issever H, Barbaros U, Adalet I, Dizdaroglu F, et al. The positive effect of adenoma weight and oxyphil cell content on preoperative localization with 99mTc-sestamibi scanning for primary hyperparathyroidism. Am J Surg. 2008;195(1):34–9.PubMedCrossRefPubMedCentralGoogle Scholar
  73. 73.
    Hundahl SA, Fleming ID, Fremgen AM, Menck HR. Two hundred eighty-six cases of parathyroid carcinoma treated in the U.S. between 1985–1995: a National Cancer Data Base Report. Cancer. 1999;86:538–44.PubMedCrossRefPubMedCentralGoogle Scholar
  74. 74.
    Parisien M, Silverberg SJ, Shane E, Dempster DW, Bilezikian JP. Bone disease in primary hyperparathyroidism. Endocrinol Metab Clin North Am. 1990;19:19–34.PubMedCrossRefPubMedCentralGoogle Scholar
  75. 75.
    Kao CL, Chang JP, Lin JW, Lin CC. Brown tumor of the sternum. Ann Thorac Surg. 2002;73:1651–3.PubMedCrossRefPubMedCentralGoogle Scholar
  76. 76.
    Ozkan E, Arslan N, Arslanoglu A, Karacalioglu AO. Decreased Tc-99m sestamibi uptake in a sternal brown tumor indicating response to anti metabolic therapy for secondary hyperparathyroidism. Clin Nucl Med. 2007;32(8):661–2.PubMedCrossRefPubMedCentralGoogle Scholar
  77. 77.
    Niyaz K, Ahmed A, Mehboob J, Hussain W, UzZaman M, Hameed A. False-positive mediastinal parathyroid adenoma on 99mTc-MIBI scanning in a patient with parathyroid carcinoma. Pak J Nucl Med. 2011;1:24–5.Google Scholar
  78. 78.
    Maruani G, Hertig A, Paillard M, Houillier P. Normocalcemic primary hyperparathyroidism: evidence for a generalized target-tissue resistance to parathyroid hormone. J Clin Endocrinol Metab. 2003;88:4641–8.PubMedCrossRefPubMedCentralGoogle Scholar
  79. 79.
    Silverberg SJ, Bilezikian JP. “Incipient” primary hyperparathyroidism: a “forme fruste” of an old disease. J Clin Endocrinol Metab. 2003;88:5348–52.PubMedCrossRefPubMedCentralGoogle Scholar
  80. 80.
    Rao DS, Wilson RJ, Kleerekoper M, Parfitt AM. Lack of biochemical progression or continuation of accelerated bone loss in mild asymptomatic primary hyperparathyroidism: evidence for biphasic disease course. J Clin Endocrinol Metab. 1988;67:1294–8.PubMedCrossRefPubMedCentralGoogle Scholar
  81. 81.
    Thomas P, Lebrun C. Progressive spastic paraparesis revealing primary hyperparathyroidism. Neurology. 1994;44(1):18–9.CrossRefGoogle Scholar
  82. 82.
    Mallet E, Castanet M. Primary hyperparathyroidism in neonates and children. In: Licata AA, Lerma EV, editors. Diseases of the parathyroid glands. New York, NY: Springer Science+Business Media; 2012.Google Scholar
  83. 83.
    Pirson A-S, Bouazza S, Krug B, Bostan S, Nollevaux M-C, Michel L, Donckier J, Vander Borght T. Unusual parathyroid adenoma avid for both Tc-99m sestamibi and I-123 iodine. Clin Nucl Med. 2010;35(11):888–90.PubMedCrossRefPubMedCentralGoogle Scholar
  84. 84.
    Leslie WD, Riese KT, Guzman R, Dupont JO, Peterdy AE. Technetium-99m-pertechnetate uptake by intrathyroidal parathyroid adenoma. J Nucl Med. 1996;37:861–2.PubMedPubMedCentralGoogle Scholar
  85. 85.
    Bergson EJ, Heller KS. The clinical significance and anatomic distribution of parathyroid double adenomas. J Am Coll Surg. 2004;198(2):185–9.PubMedCrossRefPubMedCentralGoogle Scholar
  86. 86.
    Uden P, Chan A, Duh QY, et al. Primary hyperparathyroidism in younger and older patients: symptoms and outcome of surgery. World J Surg. 1992;16:791–8.PubMedCrossRefPubMedCentralGoogle Scholar
  87. 87.
    Henry JF, Sebag F. Applied embryology of the parathyroid glands. Vestn Khir Im I I Grek. 2006;165(5):41–4.PubMedPubMedCentralGoogle Scholar
  88. 88.
    Evangelista L, Cervino AR, Gregianin M, Saladini G. FDG-PET/CT visualizes a case of primary hyperparathyroidism in a patient with gastrointestinal stromal tumor. Thyroid Sci. 2010;5(4):1–4.Google Scholar
  89. 89.
    Neumann DR, Esselstyn CB, Maclntyre WJ, Go RT, Obuchowski NA, Chen EQ, Licata AA. Comparison of FDG-PET and sestamibi-SPECT in primary hyperparathyroidism. J Nucl Med. 1996;37:1809–15.PubMedPubMedCentralGoogle Scholar
  90. 90.
    Kluijfhout WP, Pasternak JD, Drake FT, Beninato T, Gosnell JE, Shen WT, Duh Q-Y, Allen IE, et al. Use of PET tracers for parathyroid localization: a systematic review and meta-analysis. Langenbecks Arch Surg. 2016;401:925–35.PubMedPubMedCentralCrossRefGoogle Scholar
  91. 91.
    Pontikides N, Karras S, et al. Diagnostic and therapeutic review of cystic parathyroid lesions. Hormones (Athens). 2012;11(4):410–8.CrossRefGoogle Scholar
  92. 92.
    Krishnasamy S, Moulik P, Macleod A. Ectopic parathyroid cyst presenting with parathyroid crisis. Endoc Abs. 2012;28:82.Google Scholar
  93. 93.
    Shields TW, Immerman SC. Mediastinal parathyroid cysts revisited. Ann Thorac Surg. 1999;67(2):581–90.PubMedCrossRefPubMedCentralGoogle Scholar
  94. 94.
    da Silva DA, Machado MC, Brito LL, Renato A, et al. Parathyroid cysts: diagnosis and treatment. Rev Bras Otorrinolaringol. 2004;70(6):840–4.CrossRefGoogle Scholar
  95. 95.
    Agarwal A, George RK, Gupta SK, Mishra SK. Pancreatitis in patients with primary hyperparathyroidism. Indian J Gastroenterol. 2003;22:224–5.PubMedPubMedCentralGoogle Scholar
  96. 96.
    Koppelberg T, Bartsch D, Printz H, Hasse C, Rothmund M. Pancreatitis in primary hyperparathyroidism (pHPT) is a complication of advanced pHPT. Dtsch Med Wochenschr. 1994;119:719–24.PubMedCrossRefPubMedCentralGoogle Scholar
  97. 97.
    Husova L, Senkyrik M, Lata J, Hrbkova V, Husa P, Dolina J, Podral M, Ourednicek P. Acute pancreatitis as the road to diagnosis of primary hyperparathyroidism. Vnitr Lek. 2000;46:724–7.PubMedPubMedCentralGoogle Scholar
  98. 98.
    Abdullah M. Pancreatitis in primary hyperparathyroidism. Med J Malaysia. 2003;58:600–3.PubMedPubMedCentralGoogle Scholar
  99. 99.
    Frick TW, Mithöfer K, Fernández-del CC. Hypercalcemia causes acute pancreatitis by pancreatic secretory block, intracellular zymogen accumulation, and acinar cell injury. Am J Surg. 1995;169(1):167–72.PubMedCrossRefPubMedCentralGoogle Scholar
  100. 100.
    Foroulis CN, Rousogiannis S, Lioupis C, et al. Ectopic paraesophageal mediastinal parathyroid adenoma, a rare cause of acute pancreatitis. World J Surg Oncol. 2004;2:41.PubMedPubMedCentralCrossRefGoogle Scholar
  101. 101.
    Rasulova N, Siraj QH, Javaid A, Al-Banna A. Functional ectopic cystic parathyroid adenomas: case reports and literature review. Pak J Nucl Med. 2016;6:63–8.Google Scholar
  102. 102.
    Gayatri P, Sanjay D, Ajay N, Amrut A. Mixed multilocular ectopic thymic cyst with parathyroid element presenting as neck mass. Ann Acad Med Singapore. 2012;41(6):271–2.PubMedPubMedCentralGoogle Scholar
  103. 103.
    Rivkees SA, el-Hajj-Fuleihan G, Brown EM, Crawford JD. Tertiary hyperparathyroidism during high phosphate therapy of familial hypophosphatemic rickets. J Clin Endocrinol Metab. 1992;75:1514–8.PubMedPubMedCentralGoogle Scholar
  104. 104.
    Rahbari R, Holloway AK, He M, Khanafshar E, Clark OH, Kebebew E. Identification of differentially expressed microRNA in parathyroid tumors. Ann Surg Oncol. 2011;18:1158–65.PubMedCrossRefPubMedCentralGoogle Scholar
  105. 105.
    Parfitt AM. Osteomalacia and related disorders. In: Avioli LV, Krane SM, editors. Metabolic bone disease and clinically related disorders. 3rd ed. Philadelphia, PA: Saunders; 1998. p. 328–86.Google Scholar
  106. 106.
    Williams ED. Pathology of the parathyroid glands. Clin Endocrinol Metab. 1974;3:285–303.PubMedCrossRefPubMedCentralGoogle Scholar
  107. 107.
    Sathekge MM, Mageza RB, Muthuphei MN, Modiba MC, Clauss RC. Evaluation of thyroid nodules with technetium-99m MIBI and technetium-99m pertechnetate. Head Neck. 2001;23(4):305–10.PubMedCrossRefPubMedCentralGoogle Scholar
  108. 108.
    Giovanella L, Suriano S, Maffioli M, Ceriani L, Spriano G. 99mTc-sestamibi scanning in thyroid nodules with non-diagnostic cytology. Head Neck. 2009;32(5):607–11.Google Scholar
  109. 109.
    Mendoza V, Ramírez C, Espinoza AE, et al. Characteristics of ectopic parathyroid glands in 145 cases of primary hyperparathyroidism. Endocr Pract. 2010;6:977–81.CrossRefGoogle Scholar
  110. 110.
    Moran CA, Suster S. Primary parathyroid tumors of the mediastinum. Am J Clin Pathol. 2005;124:749–54.PubMedCrossRefPubMedCentralGoogle Scholar
  111. 111.
    Jones DB, Jones JH, Lloyd HJ, Lucas PA, Wilkins WE, Walker DA. Changes in blood pressure and renal function after parathyroidectomy in primary hyperparathyroidism. Postgrad Med J. 1983;59:350–3.PubMedPubMedCentralCrossRefGoogle Scholar
  112. 112.
    Kristoffersson A, Backman C, Granqvist K, Järhult J. Pre- and postoperative evaluation of renal function with five different tests in patients with primary hyperparathyroidism. J Intern Med. 1990;227:317–24.PubMedCrossRefPubMedCentralGoogle Scholar
  113. 113.
    Goltzman D. PTH action on the skeleton. In: Bilezikian JP, Marcus R, Levine MA, Marcocci C, Silverberg SJ, Potts JT, editors. The parathyroids: basic and clinical concepts. 3rd ed. London: Academic Press; 2014.Google Scholar
  114. 114.
    Khan A, Hanley D, Rizzoli R, Bollerslev J, Young J, Rejnmark L, Thakker R, D’Amour P, Paul T, Van Uum S. Primary hyperparathyroidism: review and recommendations on evaluation, diagnosis, and management. A Canadian and International Consensus. Osteoporos Int. 2017;28:1–19.PubMedCrossRefPubMedCentralGoogle Scholar
  115. 115.
    Ioannis P, Stavros P, Nektarios K, Chrysa S, Kalliopi P, et al. Water-clear cell adenoma of parathyroid gland: a case report and concerns on differential diagnosis. J Endocrinol Diabetes Obes. 2018;6(1):1117.Google Scholar
  116. 116.
    Lynn J, Lewis P. Pathological spectrum of parathyroid disease. In: Arora A, Tolley NS, Tuttle RM, editors. A practical manual of thyroid and parathyroid disease. Chichester: Wiley-Blackwell; 2010. p. 164–73.Google Scholar
  117. 117.
    Cetani F, Marcocci C. Parathyroid carcinoma. In: Bilezikian JP, Marcus R, Levine MA, Marcocci C, Silverberg SJ, Potts JT, editors. The parathyroids: basic and clinical concepts. 3rd ed. London: Elsevier; 2014.Google Scholar
  118. 118.
    Mehta NY, Ruda JM, Kapadia S, Boyer PJ, Hollenbeak CS, Stack BC Jr. Relationship of technetium Tc-99m sestamibi scans to histopathological features of hyperfunctioning parathyroid tissue. Arch Otolaryngol Head Neck Surg. 2005;131(6):493–8.PubMedCrossRefPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Qaisar Hussain Siraj
    • 1
  1. 1.Department of Nuclear MedicineFarwaniya HospitalKuwaitKuwait

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