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Carullo J, Bani J, Averous G, Helali M, Heimburger C, Vix M, Imperiale A. Hyperfunctioning Intrathyroidal Parathyroid: a Misleading Preoperative Diagnosis. Nucl Med Mol Imaging 2023; 57:46-50. [PMID: 36643944 PMCID: PMC9832180 DOI: 10.1007/s13139-022-00783-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 09/09/2022] [Accepted: 11/11/2022] [Indexed: 11/21/2022] Open
Abstract
Hyperfunctioning parathyroid glands may be rarely located in the thyroidal parenchyma and not identified by imaging or during surgical procedures. We present three patients with primary hyperparathyroidism related to hyperfunctioning intrathyroidal parathyroid retrospectively selected among 732 cases from own Institutional parathyroid PET/CT registry from 2018 to 2022. Intrathyroidal parathyroids showed intense 18F-fluorocholine uptake but a variable echographic pattern, inconstant 99mTc-MIBI uptake, and atypic iodine-contrast enhancement. Although rare, the possibility of an intrathyroidal parathyroid should be considered when no hyperfunctioning gland is found on preoperative imaging and thorough bilateral neck exploration.
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Affiliation(s)
- Josefina Carullo
- Nuclear Medicine and Molecular Imaging, Institut de Cancérologie de Strasbourg Europe (ICANS), 17, Rue Albert Calmette, 670933 Strasbourg, France
- Nuclear Medicine, Sanatorio Allende S.A, Cordoba, Argentina
| | - Jacob Bani
- Nuclear Medicine and Molecular Imaging, Institut de Cancérologie de Strasbourg Europe (ICANS), 17, Rue Albert Calmette, 670933 Strasbourg, France
| | - Gerlinde Averous
- Pathology, Strasbourg University Hospitals, University of Strasbourg, Strasbourg, France
| | - Mehdi Helali
- Nuclear Medicine and Molecular Imaging, Institut de Cancérologie de Strasbourg Europe (ICANS), 17, Rue Albert Calmette, 670933 Strasbourg, France
| | - Celine Heimburger
- Nuclear Medicine and Molecular Imaging, Institut de Cancérologie de Strasbourg Europe (ICANS), 17, Rue Albert Calmette, 670933 Strasbourg, France
- Nuclear Medicine, Hopital Civil de Haguenau, Haguenau, France
| | - Michel Vix
- General, Digestive and Endocrine Surgery, IRCAD-IHU, Strasbourg University Hospitals, Strasbourg, France
| | - Alessio Imperiale
- Nuclear Medicine and Molecular Imaging, Institut de Cancérologie de Strasbourg Europe (ICANS), 17, Rue Albert Calmette, 670933 Strasbourg, France
- Strasbourg University Hospitals, Strasbourg, France
- Molecular Imaging – DRHIM, IPHC, UMR 7178, CNRS/University of Strasbourg, Strasbourg, France
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Rueda MA, Bernal P, Ucros G. Re: Dual-Time-Point 18 F-Fluorocholine PET/CT Improves Characterization of Thyroid Nodules in Patients Referred for Primary Hyperparathyroidism: A Proof-of-Concept Study. Clin Nucl Med 2022; 47:e670. [PMID: 35261356 DOI: 10.1097/rlu.0000000000004101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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