Detection of an Intrathymic Parathyroid Adenoma Using Single-Photon Emission CT 99mTc Sestamibi Scintigraphy and CT
Paige B. Clark1,
Nancy D. Perrier2,3 and
Kathryn A. Morton1,4
1 Department of Radiology/Nuclear Medicine, Wake Forest University School of
Medicine, Medical Center Blvd., Winston-Salem, NC 27157.
2 Department of Surgery, Wake Forest University School of Medicine,
Winston-Salem, NC.
3 Present address: Department of Surgical Oncology, University of Texas M. D.
Anderson Cancer Center, Houston, TX.
4 Present address: Department of Radiology, University of Utah Health Sciences
Center, Salt Lake City, UT.

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Fig. 1A. 19-year-old man with recurrent hyperparathyroidism. Previous
minimally invasive parathyroidectomy and cervical exploration were not
curative. Ectopic parathyroid adenoma was suspected. Anterior planar images
show no focus of activity suggesting parathyroid adenoma.
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Fig. 1B. 19-year-old man with recurrent hyperparathyroidism. Previous
minimally invasive parathyroidectomy and cervical exploration were not
curative. Ectopic parathyroid adenoma was suspected. Axial 99mTc
MIBI SPECT image shows focus of increased activity (arrow) in
anterior mediastinum caudal to level of aortic arch.
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Fig. 1C. 19-year-old man with recurrent hyperparathyroidism. Previous
minimally invasive parathyroidectomy and cervical exploration were not
curative. Ectopic parathyroid adenoma was suspected. Coronal 99mTc
MIBI SPECT image shows focus of increased activity (arrow) in
anterior mediastinum caudal to level of aortic arch.
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Fig. 1D. 19-year-old man with recurrent hyperparathyroidism. Previous
minimally invasive parathyroidectomy and cervical exploration were not
curative. Ectopic parathyroid adenoma was suspected. Axial contrast CT of neck
and chest confirmed hyperattenuating nodule (arrow) within residual
thymic tissue, corresponding to 99mTc MIBI SPECT focus.
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Fig. 2. Thorascopic thymectomy was performed in the same 19-year-old
man. Histologic examination revealed 0.8 x 0.6 cm, 308-mg parathyroid
adenoma (arrowhead) surrounded by normal thymus (arrow).
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Copyright © 2005 by the American Roentgen Ray Society.