What is the typical ultrasound appearance of a parathyroid adenoma?
Rounded, hypoechoic lesion with increased vascularization. However, ultrasound characteristics may vary.
What additional method can be used to verify that a lesion identified with ultrasound is indeed a parathyroid adenoma?
Why perform a Tc99m-sestamibi scan in a patient with a negative ultrasound?
1) To detect a parathyroid adenoma that might have been missed 2) To detect ectopic adenomas in locations inaccessible by ultrasound, e.g. retrosternal
The parathyroid glands are usually located adjacent to the thyroid. Sometimes, however, parathyroid glands can be found elsewhere. What are common locations for ectopic parathyroid glands?
- Superior mediastinum - Intrathymic - Intrathyroidal - Submandibular - Retro-/paraesophageal
Immediately caudal to the left thyroid lobe, there is punctate uptake in the early phase (15 min registration) that remains active during the late phase (2 hours). The localisation of this uptake matches the lesion identified with ultrasound, thus proving it to be a parathyroid adenoma.