Thymic carcinoid and parathyroid hyperplasia detection with 99mTc-MIBI men type 1.
We report a case of a 35-year-old male, with a history of diarrhea, renal lithiasis with frequent expulsions of calculus and hypercalcemia during the last 2 years. The patient was studied and diagnosed with a multiple endocrine neoplasia type I (MEN I), familiar (mother with MEN I). A scintigraphic study with 99mTc-MIBI was performed in order to localize hyperfunctioning parathyroid glands because of biochemical diagnosis of primary hyperparathyroidism. Double phase 99mTc-MIBI scan detected one hyperfunctioning parathyroid gland and a large anterior mediastinal mass. Subsequent, plain radiograph and CT of the chest showed a soft-tissue mass in that localization. Punch biopsy of the lesion guided by CT revealed malignant cells of neuroendocrine tumor. The tumor was removed and histologically confirmed as a carcinoid within a thymus in a MEN type I syndrome. MEN I patients can benefit from the examination with this agent which can potentially localize not only parathyroid endocrine pathology but also unknown associated tumors.
Marí
C
C
Nuclear Medicine Department, Hospital Sant Pau, Barcelona, Spain.
León
J
J
Farrerons
J
J
Matis-Guiu
X
X
Tembl
A
A
Martin
J C
JC
Flotats
A
A
Bernà
L l
Ll
D000328:Adult; D002276:Carcinoid Tumor / Q000000981:diagnostic imaging*; D003967:Diarrhea / Q000150:complications; D006801:Humans; D006965:Hyperplasia; D007669:Kidney Calculi / Q000150:complications / Q000000981:diagnostic imaging; D008297:Male; D008479:Mediastinal Neoplasms / Q000150:complications / Q000000981:diagnostic imaging; D018761:Multiple Endocrine Neoplasia Type 1 / Q000150:complications / Q000000981:diagnostic imaging*; D010280:Parathyroid Glands / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D013953:Thymus Neoplasms / Q000150:complications / Q000000981:diagnostic imaging*