4. Doherty GM, Weber B, Norton JA. Cost of unsuccessful surgery for primary hyperparathyroidism. Surgery. 1994;116:954--7. 5. Fayet P, Hoeffel C, Fulla Y, Legmann P, Hazebroucq V, Luton J, et al. Technetium-99m sestamibi scintigraphy, magnetic resonance imaging and venous blood sampling in persistent and recurrent hyperparathyroidism. Br J Radiol. 1997;70:459--64. 6. Jaskowiak N, Norton JA, Ale...

Parathyroid cysts rarely cause hyperparathyroidism. In addition, they rarely occur in the thymus. We report a 56-year-old woman with hypertension on telmisartan and hydrochlorothiazide, who developed symptomatic hypercalcemia for a month. Initial serum calcium was 15.6 mg/dL, together with inappropriately elevated intact PTH at 437 pg/mL. Coincidentally, an anterior mediastinal mass on chest im...

Background Among all hereditary cancer syndromes MEN Type 1 and 2 are characterized by the concurrent but independent appearance of benign as well as malignant tumours. Neoplasias of parathyroid glands, pancreas, pituitary gland as well as neuroendocrine tumours of the stomach and intestinal wall are typical for MEN 1. Medullary thyroid carcinomas together with parathyroid adenomas and phaeochr...

Localization of 99mTc- hexakis-2-methoxyisobutylisonitrile (99mTc-MIBI) by parathyroid adenomas is well known, and this warrants MIBI scan to evaluate suspected parathyroid adenoma in primary hyperparathyroidism. Typically, the radionuclide concentrates in both the thyroid gland and parathyroid adenoma in early images, and later on delayed images washes out slowly from the...

Primary hyperparathyroidism is a common condition that affects 0.3% of the general population. Primary and tertiary care specialists can encounter patients with primary hyperparathyroidism, and prompt recognition and treatment can greatly reduce morbidity and mortality from this disease. In this paper we will review the basic physiology of calcium homeostasis and then consider genetic associati...

Consideration of Submandibular (Undescended) Ectopic Parathyroid Glands in Surgery and Localization Studies Anatomyof theparathyroidglandsvaries.Duringembryogenesis, precursor glands descend from the third and fourth pharyngeal pouches into the neck, but up to 20% end up in “ectopic” locations.1 Adenomas that develop fromundescended glands in the submandibular region aredifficult to identify on...

The sestamibi scan (MIBI) and ultrasound (US) are used for preoperative localization of parathyroid adenoma (PTA), with sensitivity as high as 90%. We developed 4-dimensional magnetic resonance imaging (4D MRI) as a novel tool for identifying PTAs. Eleven patients with PTA were enrolled. 4D MRI from the mandible to the aortic arch was used. Optimization of the timing of image acquisition was ob...

UNLABELLED Various methodologies for (99m)Tc-sestamibi parathyroid scintigraphy are in clinical use. There are few direct comparisons between the different methods and even less evidence supporting the superiority of one over another. Some reports suggest that SPECT is superior to planar imaging. The addition of CT to SPECT may further improve parathyroid adenoma localization. The purpose of ou...

Parathyroid cysts (PC) are an unusual cause of neck swellings. The majority are nonfunctioning and prove to be a diagnostic challenge given their nonspecific physical and radiological characteristics. This is compounded by their rare occurrence, leading them to be overlooked in the differential diagnosis of neck lumps. Imaging techniques fail to determine the origin of these lesions, but a preo...