False-Positive Parathyroid Sestamibi in Minimally Invasive Radioguided Parathyroidectomy.
- Author:
Jandee LEE
1
;
Seung Hyun KIM
;
Hang Seok CHANG
;
Woong Youn CHUNG
;
Cheong Soo PARK
Author Information
1. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea. ysurg@yumc.yonsei.ac.kr
- Publication Type:Case Report
- Keywords:
False-positive (99m)Tc-sestamibi scan;
Minimally invasive radio-guided parathyroidectomy (MIRGP);
Parathyroid adenoma;
Parathyroid hyperplasia
- MeSH:
Carcinoma, Papillary;
Female;
Humans;
Hyperplasia;
Middle Aged;
Mitochondrial Membranes;
Parathyroid Neoplasms;
Parathyroidectomy*;
Pathology;
Thyroid Diseases;
Thyroid Gland;
Thyroid Neoplasms
- From:Journal of the Korean Surgical Society
2006;70(2):144-147
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
A (99m)Tc-sestamibi scan has become the most widely used localizing test for identifying a parathyroid adenoma. Despite its popularity, the effectiveness of (99m)Tc-sestamibi scan for parathyroid localization is still controversial due to the large number of false-positive results. The false positive (99m)Tc-sestamibi scan can be attributed to a thyroid adenoma, nodular hyperplasia, metastatic thyroid cancer and other proliferating thyroid diseases because (99m)Tc-sestamibi is specific to the mitochondrial membrane of cells with high-level metabolic status, and not specific to the parathyroid itself. Minimally invasive radio-guided parathyroidectomy (MIRGP) was performed on a 61 year-old woman. The (99m)Tc-sestamibi focus was completely excised with gamma-probe guidance. However, the frozen pathology showed the excised tissue to be a thyroid papillary carcinoma. We present the unexpected false-positive (99m)Tc-sestamibi in MIRGP, and discuss the considerations in order to reduce the number of false-positive parathyroid (99m)Tc-sestamibi scans.
