CASE 1: 61 year old doctor
Imaging for parathyroid adenoma: SestaMIBI scan on the left and intra-operative ultrasound on the right.
A wedge resection of the lower pole of the thyroid gland was carried out and histology examination confirmed the presence of a parathyroid adenoma within the thyroid gland.
This is an uncommon, but well known occurrence. Just 1% of parathyroid adenomas will exist within the thyroid gland substance.
Post surgery the serum calcium and PTH rapidly returned to normal levels – 2.35 and the PTH level to 6.1.
Lessons From the Interesting Case:
Sophisticated imaging with 4D-CT and SESTAMIBI / SPECT techniques will not always identify parathyroid adenoma.
Thorough knowledge and experience of common and uncommon variations in position of parathyroid glands is required to achieve success in some cases.
The use of intra-operative ultrasound techniques can also be extremely useful.