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Hyperfunctioning parathyroid gland as a cause of hyperparathyroidism and osteodystrophy – a case report


Authors: Petra Malinová 1;  Otto Lang 1,2
Authors‘ workplace: Klinika nukleární medicíny, 3. LF UK a FN Královské Vinohrady, Praha 10 1;  Oddělení nukleární medicíny, Oblastní nemocnice Příbram, a. s., Příbram, ČR 2
Published in: NuklMed 2020;9:30-33
Category: Casuistry

Overview

Aim: To present a case report emphazing the importance of nuclear medicine methods in differential diagnosis of endocrine diseases affecting bone metabolism.

Case report: 72-y-old female patient with breast cancer history, chronic kidney disease and suspected primary hyperparathyroidism was referred to our department for a bone scan. The bone scintigraphy, performed 2 hours after 800 MBq 99mTc-HDP intravenous administration, revealed increased uptake in both femurs, intense diffuse uptake in the skull and faint uptake in kidneys, which was compatible with metabolic superscan pattern. Subsequent parathyroid scan with 812 MBq 99mTc-MIBI (using dual time-point imaging) disclosed focus of high uptake and delayed wash-out nearby the lower part of right thyroid lobe and therefore successfully confirmed and located suspected hyperfunctioning parathyroid gland.

Conclusion: Bone scan revealed osseous metabolic changes due to hyperparathyroidism and parathyroid scan precisely located hyperfunctioning parathyroid gland.

Keywords:

primary hyperthyroidism – osteodystrophy – bone scintigraphy – parathyroid gland scintigraphy


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Nuclear medicine Radiodiagnostics Radiotherapy
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