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2020, Number 3

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Rev cubana med 2020; 59 (3)

Primary hyperparathyroidism due to negative scintigraphy adenoma

Infante-Amorós A, Rodríguez-Martínez K, Arguelles ZAC, Ramírez-Izcoa A, Condori-Villca N

Language: Spanish
References: 18
Page: 1-7
PDF size: 292.51 Kb.


ABSTRACT

Introduction: Hyperparathyroidism is one of the most frequent causes of hypercalcemia. 85% of patients are older than thirty years, its highest frequency is over 60 years, in the long term it can produce a series of complications.
Objective: To describe a clinical case of primary hyperparathyroidism that was negative in the scintigraphy study with ectopic location of the adenoma.
Clinical case report: A 20-year-old female patient with a 7-year history of renal and urethral lithiasis, who had undergone 13 lithotripsy sessions and two recurrent kidney surgeries. Six months ago, elevated calcium levels were detected. A study protocol for hypercalcemia was carried out, determining primary hyperparathyroidism. Ultrasound and neck tomography report a lesion that could correspond to a paratracheal parathyroid adenoma; however, methoxy-isobutylisonitrile and technetium-99 scintigraphy was negative. Conventional neck surgery was performed since radioguided surgery was not useful for locating the intraoperative parathyroid adenoma. Histopathological study reported parathyroid adenoma.
Conclusions: In parathyroid adenomas with negative scintigraphy, the diagnosis can be reached with conventional imaging studies. The ectopic location of the parathyroid adenoma is a cause of negative scintigraphy. Radioguided surgery is not helpful in scan-negative ectopic parathyroid adenomas.


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