Endocrinol Metab > Volume 26(2); 2011 > Article
Endocrinology and Metabolism 2011;26(2):166-170.
DOI: https://doi.org/10.3803/EnM.2011.26.2.166    Published online June 1, 2011.
A Case of Primary Hyperparathyroidism Caused by Solitary Parathyroid Adenoma That was Not Detected by Both Ultrasonography and Sestamibi Scan.
Kyong Yong Oh, Byoungho Choi, Yukyung Lee, Do Hwan Kim, Hyon Seung Yi, Kwang Jun Kim, Sihoon Lee, Sung Kil Lim
1Department of Internal Medicine, Gachon University School of Medicine, Incheon, Korea. shleemd@gachon.ac.kr
2Department of Nuclear Medicine, Gachon University School of Medicine, Incheon, Korea.
3Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.
4Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Thanks to advances in assay techniques and routine measurements in serum chemical analysis, primary hyperparathyroidism has become far more frequently detected, and the number of asymptomatic patients has substantially increased. In the majority of patients (85%), a solitary adenoma is the underlying cause of primary hyperparathyroidism. Surgical excision is the treatment of choice for most cases of primary hyperparathyroidism; this procedure has a relatively high success rate. In the past decade, improvements in preoperative imaging have played a major role in a targeted operative approach, which allows for minimally invasive surgery to be performed. The success of parathyroid surgery depends on the accurate preoperative localization of parathyroid adenoma. In this study, we report the case of a 54 year-old woman with primary hyperparathyroidism who presented with left buttock and leg pain. For localization of the parathyroid lesion, an ultrasonography and a 99mTc-sestamibi scan were initially performed, but these attempts failed to localize the lesion. We then carried out contrast-enhanced CT; thereafter, a single parathyroid adenoma was detected. Therefore, in patients with negative results on both ultrasonography and 99mTc-sestamibi scan, contrast-enhanced CT may prove helpful for preoperative parathyroid localization.
Key Words: Primary hyperparathyroidism, Parathyroid adenoma, Computerized tomography

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