Appearance of ectopic undescended inferior parathyroid adenomas on technetium Tc 99m sestamibi scintigraphy: A lesson from reoperative parathyroidectomy

David Axelrod; James C Sisson; KYUNG Cho; Judiann Miskulin; Paul G Gauger

doi:10.1001/archsurg.138.11.1214

Back

Appearance of ectopic undescended inferior parathyroid adenomas on technetium Tc 99m sestamibi scintigraphy: A lesson from reoperative parathyroidectomy

Journal article

Peer reviewed

Appearance of ectopic undescended inferior parathyroid adenomas on technetium Tc 99m sestamibi scintigraphy: A lesson from reoperative parathyroidectomy

David Axelrod, James C Sisson, KYUNG Cho, Judiann Miskulin and Paul G Gauger

Archives of surgery (Chicago. 1960), Vol.138(11), pp.1214-1218

2003

DOI: 10.1001/archsurg.138.11.1214

PMID: 14609869

View Online

Abstract

Hypothesis: Critical postoperative review of technetium Tc 99m sestamibi scintigraphy can identify an undescended parathyroid adenoma on scans initially interpreted as nondiagnostic or negative. Design: Case series. Setting: A single, tertiary care academic medical center. Patients: Three patients with persistent hyperparathyroidism. Intervention: Technetium Tc 99m sestamibi scanning. Outcome Measure: Medical records, operative reports, selective venous sampling results, and sestamibi scans were reviewed to identify scintigraphic findings diagnostic of an undescended parathyroid adenoma. Results: All patients were cured of their persistent or recurrent hyperparathyroidism during reoperation by resection of an undescended inferior parathyroid adenoma. Subsequent review of the preoperative sestamibi scans demonstrated scintigraphic evidence of the undescended adenoma. In each case there was asymmetry in the physiologic activity attributed to the ipsilateral submandibular gland that, in fact, corresponded to an ectopic parathyroid adenoma at the level of the carotid bifurcation. Conclusions: Careful attention to the contour of radioactivity in the region of the submandibular salivary gland may alert surgeons to the presence of an undescended inferior adenoma. After corroboration, this finding may facilitate a targeted operation.

Biological and medical sciences

Endocrinopathies

Medical sciences

Non tumoral diseases. Target tissue resistance. Benign neoplasms

Parathyroids. Parafollicular cells. Cholecalciferol. Phosphocalcic homeostasis (diseases)

Details

Title: Subtitle: Appearance of ectopic undescended inferior parathyroid adenomas on technetium Tc 99m sestamibi scintigraphy: A lesson from reoperative parathyroidectomy
Creators: David Axelrod - University of Michigan
James C Sisson - University of Michigan Medical School
KYUNG Cho - University of Michigan Medical School
Judiann Miskulin - University of Michigan Medical School
Paul G Gauger - University of Michigan Medical School
Resource Type: Journal article
Publication Details: Archives of surgery (Chicago. 1960), Vol.138(11), pp.1214-1218
DOI: 10.1001/archsurg.138.11.1214
PMID: 14609869
NLM abbreviation: Arch Surg
ISSN: 0004-0010
eISSN: 1538-3644
Publisher: American Medical Association
Language: English
Date published: 2003
Academic Unit: Surgery
Record Identifier: 9984322944202771

Metrics

21 Record Views

10 Times Cited - Web of Science