A Patient with Classic Severe Primary Hyperparathyroidism in Whom both Tc-99m MIBI Scintigraphy and FDG-PET Failed to Detect the Parathyroid Tumor
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概要
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A 24-year-old woman was admitted to our department for further examination of hypercalcemia, a high level of intact parathyroid hormone (PTH) and a right parathyroid tumor. She complained of bone pain throughout her body and was unable to walk due to systemic cystic osteofibrosis, including a brown tumor of the left lower extremities. Neck ultrasonography (US) and magnetic resonance imaging (MRI) revealed a tumor 2 cm in diameter in the upper side of the right thyroid lobe. 99mTc sestamibi (99mTc-MIBI) imaging and F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) were performed to diagnose primary hyperparathyroidism and examination of other parathyroid glands. However, neither imaging modality detected the parathyroid tumor. To confirm the diagnosis, we performed selective venous sampling around the parathyroid and the patient was diagnosed with primary hyperparathyroidism due to a right parathyroid tumor. Resection of the right parathyroid tumor was performed and the pathological diagnosis was parathyroid adenoma. To date, both 99mTc-MIBI and FDG-PET are useful to localize parathyroid tumors. In this case, however, neither modality detected the tumor. Although recent studies state that expression of P-glycoprotein (P-gp) in parathyroid tumors plays an important role in the false-negative results of both 99mTc-MIBI scans and FDG-PET, immunohistological study detected no P-gp expression in the parathyroid tumor in the current case.
- 社団法人 日本内科学会の論文
- 2004-09-01
著者
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MATSUMOTO Hiroshi
Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurolo
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Mori Masatomo
Department Of Medicine And Molecular Science Gunma University Graduate School Of Medicine
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SATOH TETUROU
Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine
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Mori M
Department Of Medicine And Molecular Science Gunma University Graduate School Of Medicine
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MAEDA Masaki
Department of Engineering Physics, Electronics and Mechanics, Graduate School of Engineering, Nagoya
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Seki Kaori
Department of Cardiology, Matsushita Memorial Hospital, Japan
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Seki Kaori
Department Of Molecular And Clinical Medicine
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Satoh Teturou
Department Of Medicine And Molecular Science Gunma University Graduate School Of Medicine
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Oyama Tetsunari
Department Of Pathology Dokkyo University School Of Medicine
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Oyama Tetsunari
Department Of Pathology Gunma University Graduate School Of Medicine
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HISADA Takeshi
Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine
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YAMADA Masanobu
Department of Neurosurgery, The Center for Adult Diseases
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Yamada Masanobu
Department Of Medicine And Molecular Science Gunma University Graduate School Of Medicine
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Uehara Yutaka
Department Of Medicine And Molecular Science Gunma University Graduate School Of Medicine
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Uehara Yutaka
Department Of Molecular And Clinical Medicine
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HASHIMOTO Koshi
Department of Molecular and Clinical Medicine
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Hashimoto Koshi
Department Of Medicine And Molecular Science Gunma University Graduate School Of Medicine
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Mori Masatomo
Department Of Internal Medicine And Molecular Science Graduate School Of Medicine Gunma University
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Oyama Tetsunari
Department Of Pathology Dokkyo Medical School Of Medicine
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Maeda Masaki
Department Of Applied Physics Faculty Of Engineering Nagoya University
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Satoh Tetsuro
Department Of Medicine And Molecular Science Gunma University Graduate School Of Medicine
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Hisada Takeshi
Department Of Medicine And Molecular Science Gunma University Graduate School Of Medicine
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Matsumoto Hiroshi
Department Of Materials Science Toyohashi University Of Technology
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Yamada Makoto
Department Of Medicine And Molecular Science Gunma University Graduate School Of Medicine
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Oyama Tetsunari
Department Of Diagnostic Pathology Gunma University Graduate School Of Medicine
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Matsumoto Hiroshi
Department Of Architecture And Civil Engineering Toyohashi University Of Technology
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Matsumoto Hiroshi
Department Of Architecture And Civil Engineering Faculty Of Engineering Toyohashi University Of Tech
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Matsumoto Hiroshi
Department Of Surgery Maebashi Kyoritsu Hospital
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Hashimoto Koshi
Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine
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