The ineffectiveness of Technetium-99m-sestamibi for the pre-operative localization of parathyroid glands in neonatal primary hyperparathyroidism: case report

Abstract

Objective: To present the case of a child with neonatal primary hyperparathyroidism submitted to preoperative image studies that couldn't localize the parathyroid glands.Methods: Report of clinical and laboratory evaluation of neonatal primary hyperparathyroidism in a two-and-a-half-monthold child submitted to preoperative cervical ultrasonography and parathyroid scintigraphy with Technetium-99m-Sestamibi, and subtotal parathyroidectomy at the age of four-and-a -half months.Results: The preoperative images suggested an erroneous diagnosis of parathyroid adenoma. After surgery and pos-operative histopathological exams, hyperplasia of parathyroid glands was confirmed. After two years and a half the child has normal parathyroid function.Conclusions: The cervical ultrasonography and the parathyroid scintigraphy with Technetium-99m-Sestamibi were not useful for preoperative localization of hyperplasied parathyroid glands in the neonatal primary hyperparathyroidism in this case. The subtotal parathyroidectomy has been a successful method for the maintenance of normocalcemy in the patient.J. pediatr. (Rio J.). 1999; 75(4): 271-276: hyperparathyroidism, hyperkalemia, parathyroidectomy, ultrasonography, radionuclide imaging, technetium-tc-99m-sestamibi.