Violetta Rosiek1* and Beata Kos-Kudła2
1Department of Endocrinology and Neuroendocrine Tumors, Medical University of Silesia, Poland2Department of Pathophysiology and Endocrinology, Medical University of Silesia, PolandFulltext PDF
Introduction: The most common cause of primary hyperparathyroidism is adenoma. In order to locate it, we perform a neck ultrasound followed by 99mTc-MIBI parathyroid scintigraphy. However, sometimes it is impossible to localize pathological parathyroid glands in these imaging examinations. Then, as a second-line imaging, PET/CT scan with 11C-Methionine or 18F-Fluorocholine should be considered. Case Report: Fifty five-year-old patient with long-term history of recurrent nephrolithiasis, osteopenia, with primary hyperparathyroidism confirmed in biochemical and hormonal tests. 99mTcMIBI parathyroid scintigraphy was performed twice (planar method+SPECT) and no parathyroid adenoma was found. Subsequently, a PET/CT imaging with 11C-Methionine was performed in which an oval lesion measuring 7 mm × 9 mm was imaged behind the lower pole of the right thyroid lobe, suggesting a parathyroid adenoma. Conclusion: We have shown that 11C-MET PET/CT is a reliable second-line imaging to locate the parathyroid adenoma when it cannot be located in the standard imaging (neck ultrasound, Tc-99mMIBI), before the planned minimally invasive parathyroidectomy.
Primary hyperparathyroidism; 11C-methionine; PET/CT; 99mTc-MIBI parathyroid scintigraphy
Rosiek V, Kos-Kudła B. Utility of 11C-Methionine PET/CT in Preoperative Localization of a Parathyroid Adenoma in a Patient with Primary Hyperparathyroidism – Case Report and Literature Review. Clin Oncol. 2019; 4: 1641 .