Parathyroid adenoma detected with 99mTc-tetrofosmin dual-phase scintigraphy: a case report

Romanidis, Κonstantinos; Karathanos, Evangelos; Nagorni, Eleni-Aikaterini; Giatromanolaki, Alexandra; Sibridis, Efthimios; Zissimopoulos, Athanassios; Vogiatzaki, Theodosia; Simopoulos, Constantinos; Pitiakoudis, Michail

doi:10.1186/1756-0500-7-335

Cited by 8 publications

(5 citation statements)

References 10 publications

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“…Elevated levels of alkaline phosphatase can be found in 10% of cases, along with complications related to bone disease. A serum and urine protein electrophoresis examination can be conducted to eliminate the possibility of multiple myeloma [13], [14].…”

Section: Discussionmentioning

confidence: 99%

“…In some cases, PHPT could also manifest normocalcemic conditions due to a vitamin D deficiency, low serum albumin levels, excessive hydration, a high-phosphate diet, and low calcium levels in the normal range [13], [14]. In such cases, the laboratory results show concurrent levels of calcium and parathyroid hormone (PTH), with normal levels of FT4 and TSH, normal kidney function, and no signs of infection.…”

Section: Discussionmentioning

confidence: 99%

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A Case Report Surgical Treatment for Parathyroid Adenoma: A Case Report

Prihantono¹,

Palinggi²,

Haryasena³

et al. 2019

Open Access Maced J Med Sci

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BACKGROUND:Parathyroid adenoma is a rare disease. This article aimed to present the classic symptoms, diagnosis, and management of parathyroid adenoma.CASE REPORT:We report the case of a 24-year-old Asian woman with a several-month-long history of prolonged fatigue, bone, and joint pain. The patient was admitted to our hospital with multiple fractures without significant trauma. Physical examination revealed no palpable masses in the neck. The bone survey showed multiple fractures and osteoporosis of the humerus, clavicle, femur, and lumbar vertebrae. The laboratory workup showed a significantly elevated parathyroid hormone (PTH) level of 1,276 pg/ml (reference range: 10-55 pg/ml) and hypercalcemia, at 11.3 mg/dl (reference range: 8.5-10.5 mg/dl). MRI revealed enlargement of the left inferior parathyroid gland. The patient was diagnosed with a parathyroid gland tumour. Surgical resection was performed, and histopathology revealed parathyroid adenoma. The clinical manifestations and PTH and calcium levels gradually decreased to normal after the surgery. At the two-year follow-up, there was no recurrence of the disease. The patient has resumed her daily life as a farmer.CONCLUSIONS:Parathyroid adenoma has an excellent prognosis with surgical treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Case Report Surgical Treatment for Parathyroid Adenoma: A Case Report

Prihantono¹,

Palinggi²,

Haryasena³

et al. 2019

Open Access Maced J Med Sci

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“…Intraoperative frozen section and final pathology were consistent with parathyroid adenoma. See Figure 3 [4].…”

Section: Case Reportmentioning

confidence: 99%

Parathyroid Adenoma Presenting as a Giant Cystic Neck Mass

Muelleman¹,

Rosenberger²,

Humphrey³

et al. 2016

IJOHNS

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We present a case report of a parathyroid adenoma, which presented as a giant cystic neck mass while providing thorough reviews of the pathophysiology of parathyroid adenomas and the differential diagnosis for large, cystic neck masses in adults. A 72 year old female presented to a tertiary academic medical center with a complicated past medical history and was found to have an asymptomatic central neck mass which measured 10.5 × 7.7 × 4.1 cm on ultrasound and extended from the retropharyngeal space with mass effect on the hypopharynx, esophagus, trachea, and right carotid space structures as well as the superior mediastinum. She had elevated calcium and parathyroid hormone (PTH) levels. She underwent surgical excision of this mass and had an uneventful postoperative period. Large cystic neck masses generate a wide differential diagnosis. In adults, it is important to consider the rare possibility of parathyroid adenoma, especially in patients who may not be able to communicate vague symptoms of hypercalcemia. This particular parathyroid adenoma is several orders of magnitude larger than an average parathyroid adenoma and its massive size served as a distraction for the proper diagnosis as large, cystic neck masses in adults are to be considered cancer until proven otherwise.

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“…Tc-99m tetrofosmin is commonly used for myocardial perfusion imaging agent, mainly at Harapan Kita Cardiac Hospital, Jakarta and Hasan Sadikin General Hospital, Bandung [1]. However, in recent year the use of Tc-99m tetrofosmin has been expanding not only for myocardial imaging but also for detection of several tumors and cancers such as brain cancer (glioma, glioblastoma, and meningioma), breast cancer and parathyroid adenoma [2][3][4][5]. The chemical structure of Tc-99m tetrofosmin has been discussed elsewhere [6].…”

Section: Introductionmentioning

confidence: 99%

Effect of High Activity Technetium-99m on the Stability of Tc-99m Tetrofosmin as Injectable radiopharmaceuticals

Widjaksana

Widayati

Alwi

et al. 2018

J. Pure App. Chem. Res.

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Technetium-99m (Tc-99m) labeled tetrofosmin kit has been widely used in hospitals including in Indonesia. Usually, tetrofosmin kits and Tc-99m pertechnetate are supplied separately, but recently there has been a new trend where Tc-99m tetrofosmin is supplied in the form of the ready-to-inject product. To prepare such a product it has to be proven that tetrofosmin can be labeled with high activity of Tc-99m and the resulted Tc-99m tetrofosmin, remains stable within shipping time until being used in hospitals. In this investigation, locally produced tetrofosmin kits were labeled with various radioactivity of Tc-99m ranging from 150 mCi to 400 mCi, their radiolabeling yields or radiochemical purity was analyzed using SepPak C18 column, and the radiochemical stability was assessed within 30 hours. The worst storage condition was also studied by analyzing its radiochemical purity after being stored at extreme temperatures for several hours. The results showed that tetrofosmin kit can be highly labeled with up to 415 mCi of Tc-99m, and stable up to 30 hours in room temperature, and there is a tendency that higher radioactivity leads to more decreasing in radiochemical purity. Stability study in extreme temperatures showed that the product can withstand its stability within 6 hours in 40C, but it decreased rapidly to less than 70% within 1 hour when stored in 50C. It concludes that the quality of Tc-99m tetrofosmin as an injectable radiopharmaceutical can be maintained during transportation by storing it at cool temperature.

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Parathyroid adenoma detected with 99mTc-tetrofosmin dual-phase scintigraphy: a case report

Cited by 8 publications

References 10 publications

A Case Report Surgical Treatment for Parathyroid Adenoma: A Case Report

A Case Report Surgical Treatment for Parathyroid Adenoma: A Case Report

Parathyroid Adenoma Presenting as a Giant Cystic Neck Mass

Effect of High Activity Technetium-99m on the Stability of Tc-99m Tetrofosmin as Injectable radiopharmaceuticals

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