Delayed Surgery for Parathyroid Adenoma Misdiagnosed as a Thyroid Nodule and Treated with Radiofrequency Ablation

Primary hyperparathyroidism occurs as a result of isolated parathyroid adenoma in 80% to 85% of all cases. A 99mtechnetium (99mTc) sestamibi scan or neck ultrasonography is used to localize the neoplasm prior to surgical intervention. A 53-year-old female was referred for the exclusion of metabolic...

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Main Authors: Ho-Su Kim, Bong Hoi Choi, Jung Rang Park, Jong Ryeal Hahm, Jung Hwa Jung, Soo Kyoung Kim, Sungsu Kim, Kyong-Young Kim, Soon Il Chung, Tae Sik Jung
Format: Article
Language:English
Published: Korean Endocrine Society 2013-09-01
Series:Endocrinology and Metabolism
Subjects:
Online Access:http://e-enm.org/Synapse/Data/PDFData/2008ENM/enm-28-231.pdf
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author Ho-Su Kim
Bong Hoi Choi
Jung Rang Park
Jong Ryeal Hahm
Jung Hwa Jung
Soo Kyoung Kim
Sungsu Kim
Kyong-Young Kim
Soon Il Chung
Tae Sik Jung
author_facet Ho-Su Kim
Bong Hoi Choi
Jung Rang Park
Jong Ryeal Hahm
Jung Hwa Jung
Soo Kyoung Kim
Sungsu Kim
Kyong-Young Kim
Soon Il Chung
Tae Sik Jung
author_sort Ho-Su Kim
collection DOAJ
description Primary hyperparathyroidism occurs as a result of isolated parathyroid adenoma in 80% to 85% of all cases. A 99mtechnetium (99mTc) sestamibi scan or neck ultrasonography is used to localize the neoplasm prior to surgical intervention. A 53-year-old female was referred for the exclusion of metabolic bone disease. She presented with low back pain that had persisted for the past 6 months and elevated serum alkaline phosphatase (1,253 IU/L). Four years previously, she had been diagnosed at a local hospital with a 2.3-cm thyroid nodule, which was determined to be pathologically benign. Radiofrequency ablation was performed at the same hospital because the nodule was still growing during the follow-up period 2 years before the visit to our hospital, and the procedure was unsuccessful in reducing the size of the nodule. The results of the laboratory tests in our hospital were as follows: serum calcium, 14.6 mg/dL; phosphorus, 3.5 mg/dL; and intact parathyroid hormone (iPTH), 1,911 pg/mL. Neck ultrasonography and 99mTc sestamibi scan detected a 5-cm parathyroid neoplasm in the left lower lobe of the patient's thyroid; left parathyroidectomy was performed. This case indicated that thyroid ultrasonographers and pathologists need to be experienced enough to differentiate a parathyroid neoplasm from a thyroid nodule; 99mTc sestamibi scan, serum calcium, and iPTH levels can help to establish the diagnosis of parathyroid neoplasm.
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spelling doaj.art-2a666bc41b3f43b09c04791a3c165bbe2022-12-21T23:15:08ZengKorean Endocrine SocietyEndocrinology and Metabolism2093-596X2093-59782013-09-0128323123510.3803/EnM.2013.28.3.23121949Delayed Surgery for Parathyroid Adenoma Misdiagnosed as a Thyroid Nodule and Treated with Radiofrequency AblationHo-Su KimBong Hoi ChoiJung Rang ParkJong Ryeal HahmJung Hwa JungSoo Kyoung KimSungsu KimKyong-Young KimSoon Il ChungTae Sik JungPrimary hyperparathyroidism occurs as a result of isolated parathyroid adenoma in 80% to 85% of all cases. A 99mtechnetium (99mTc) sestamibi scan or neck ultrasonography is used to localize the neoplasm prior to surgical intervention. A 53-year-old female was referred for the exclusion of metabolic bone disease. She presented with low back pain that had persisted for the past 6 months and elevated serum alkaline phosphatase (1,253 IU/L). Four years previously, she had been diagnosed at a local hospital with a 2.3-cm thyroid nodule, which was determined to be pathologically benign. Radiofrequency ablation was performed at the same hospital because the nodule was still growing during the follow-up period 2 years before the visit to our hospital, and the procedure was unsuccessful in reducing the size of the nodule. The results of the laboratory tests in our hospital were as follows: serum calcium, 14.6 mg/dL; phosphorus, 3.5 mg/dL; and intact parathyroid hormone (iPTH), 1,911 pg/mL. Neck ultrasonography and 99mTc sestamibi scan detected a 5-cm parathyroid neoplasm in the left lower lobe of the patient's thyroid; left parathyroidectomy was performed. This case indicated that thyroid ultrasonographers and pathologists need to be experienced enough to differentiate a parathyroid neoplasm from a thyroid nodule; 99mTc sestamibi scan, serum calcium, and iPTH levels can help to establish the diagnosis of parathyroid neoplasm.http://e-enm.org/Synapse/Data/PDFData/2008ENM/enm-28-231.pdfParathyroid neoplasmsThyroid noduleThyroid ultrasonography
spellingShingle Ho-Su Kim
Bong Hoi Choi
Jung Rang Park
Jong Ryeal Hahm
Jung Hwa Jung
Soo Kyoung Kim
Sungsu Kim
Kyong-Young Kim
Soon Il Chung
Tae Sik Jung
Delayed Surgery for Parathyroid Adenoma Misdiagnosed as a Thyroid Nodule and Treated with Radiofrequency Ablation
Endocrinology and Metabolism
Parathyroid neoplasms
Thyroid nodule
Thyroid ultrasonography
title Delayed Surgery for Parathyroid Adenoma Misdiagnosed as a Thyroid Nodule and Treated with Radiofrequency Ablation
title_full Delayed Surgery for Parathyroid Adenoma Misdiagnosed as a Thyroid Nodule and Treated with Radiofrequency Ablation
title_fullStr Delayed Surgery for Parathyroid Adenoma Misdiagnosed as a Thyroid Nodule and Treated with Radiofrequency Ablation
title_full_unstemmed Delayed Surgery for Parathyroid Adenoma Misdiagnosed as a Thyroid Nodule and Treated with Radiofrequency Ablation
title_short Delayed Surgery for Parathyroid Adenoma Misdiagnosed as a Thyroid Nodule and Treated with Radiofrequency Ablation
title_sort delayed surgery for parathyroid adenoma misdiagnosed as a thyroid nodule and treated with radiofrequency ablation
topic Parathyroid neoplasms
Thyroid nodule
Thyroid ultrasonography
url http://e-enm.org/Synapse/Data/PDFData/2008ENM/enm-28-231.pdf
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