title: Occult fifth gland intrathyroid parathyroid adenoma identified by gamma probe.
abstract: We report the case of a 54-year-old woman undergoing radioguided parathyroidectomy in whom four normal glands were identified on cervical exploration. The gamma probe was instrumental in guiding us to the adenoma in a fifth gland that was not visible and was localized to the parenchyma of the left lobe of the thyroid gland. Many surgeons do not advocate use of the gamma probe in minimally invasive parathyroidectomy and rely solely on focused exploration on the basis of a preoperative sestamibi scan and intraoperative rapid parathyroid hormone assays. This case, however, illustrates the utility of the gamma probe in parathyroid adenoma localization.
authors.affiliation: Section of General Surgery, Mayo Clinic, Jacksonville, Florida 32224, USA.
authors.forename: Todd
authors.initials: T
authors.lastname: Berland
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Smith
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Huguet
mesh_terms: D000236:Adenoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D015902:Gamma Cameras; D006801:Humans; D006961:Hyperparathyroidism / Q000175:diagnosis / Q000209:etiology; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation; D010280:Parathyroid Glands / Q000002:abnormalities*; D010282:Parathyroid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D016105:Parathyroidectomy / Q000379:methods; D011877:Radionuclide Imaging; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi
chemical_list: D017256:Technetium Tc 99m Sestamibi