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99mTc-MIBI SPECT과 경부 CT로 진단된 이소성 부갑상선 선종 1예
김효정 ( Hyo Jeong Kim ),김진택 ( Jin Taek Kim ),이호정 ( Ho Jeong Lee ),박만실 ( Man Sil Park ),임혜진 ( Hye Jin Lim ),신동금 ( Dong Geum Shin ),김준봉 ( Jun Bong Kim ) 대한내과학회 2012 대한내과학회지 Vol.83 No.5
An ectopic parathyroid gland is a major cause of persistent and recurrent hyperparathyroidism. Surgical success depends on accurate preoperative localization of the parathyroid adenoma. We herein report the case of a 52-year-old male patient who suffered from primary hyperparathyroidism for several years. He initially presented with urinary frequency, hypercalcemia, and a ureter stone. Ultrasonography and a 99mTc-sestamibi scan were performed, but failed to localize the parathyroid lesion. Four years later, the patient revisited our hospital, complaining of general weakness, headache, dyspepsia, and recurrent urinary symptoms secondary to persistent primary hyperparathyroidism. In addition, renal function was decreased and severe osteoporosis was found. We performed a 99mTc-sestamibi scan with single photon emission computed tomography (99mTc-MIBI SPECT) and contrast- enhanced neck CT, and detected an ectopic parathyroid adenoma in the upper anterior mediastinum. In conclusion, the combination of both 99mTc-MIBI SPECT and neck CT could permit better preoperative parathyroid localization, especially for mediastinal adenomas. (Korean J Med 2012;83:641-646)