Giant Cystic and Mediastinal Parathyroid Adenoma with Non-Uptake in Scintigraphy
2018
Introduction: In 85% of patients, the cause of Primary Hyperparathyroidism (PHPT) is an
adenoma. Parathyroid adenoma localization is usually simple. 96% of
localizations prior to surgery are
achieved with ultrasound and scintigraphy combination. Difficulties can appear.
If the gland is not located in a cervical position and has no uptake in
scintigraphy but there is high suspition of an adenoma causing the PHPT, some
extra tests should be considered. Case Report: We present a case of
giant cystic mediastinal adenoma, a quite rare condition, which was diagnosed as a thyroid
colloid cyst by ultrasound, and was not localized by scintigraphy. We report
the CT scan and the magnetic
resonance imaging (MRI) images
that show the tumour. It was
surgically resected by a cervical approach. After the excision, the patient recovered normal levels of
Calcium and Parathormone (PTH). Conclusion: We review literature about
cystic and mediastinal adenomas and diagnostic methods when the standard ones
do not give an accurate localization diagnosis.
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