Distant subcutaneous recurrence of a parathyroid carcinoma: abnormal uptakes in the (99m)Tc-sestamibi scan and (18)F-FDG PET/CT imaging.
We report a rare case of distant subcutaneous parathyroid carcinoma recurrence. A 50-year-old woman was referred to our hospital because of sustained hypercalcemia despite surgical removal of a parathyroid carcinoma. A focal uptake in the upper mediastinal area was detected in a (99m)Tc-sestamibi scan, and (18)F-fluorodeoxyglucose (FDG) positron-emission tomography (PET)/computed tomography (CT) imaging demonstrated a subcutaneous mass. She underwent tumor resection, and the pathological findings were consistent with a parathyroid carcinoma. The postoperative serum parathyroid hormone (PTH) level remained within normal limits. However, a new palpable solitary mass was identified in the upper portion of the left breast 1 year postoperatively. Both a (99m)Tc-sestamibi scan and (18)F-FDG PET/CT imaging revealed an abnormal lesion in the upper breast, and subsequent pathology reports confirmed parathyroid carcinoma metastasis. Serum PTH and calcium levels fell within normal ranges after tumor resection. Two subcutaneous recurrent lesions appeared likely due to tumor seeding during the previous endoscopic operation at a local hospital.
Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
Sang Soo
SS
Kim
Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
Yun Kyung
YK
Jeon
Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
Soo Hyung
SH
Lee
Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
Bo Hyun
BH
Kim
Department of Nuclear Medicine, Pusan National University School of Medicine, Busan, Korea.
Seong Jang
SJ
Kim
Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
Yong Ki
YK
Kim
Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea.
In Ju
IJ
Kim
D015415:Biomarkers / Q000097:blood; D001943:Breast Neoplasms / Q000097:blood / Q000000981:diagnostic imaging* / Q000556:secondary* / Q000601:surgery; D002277:Carcinoma / Q000097:blood / Q000000981:diagnostic imaging* / Q000556:secondary* / Q000601:surgery; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008875:Middle Aged; D064847:Multimodal Imaging; D010281:Parathyroid Hormone / Q000097:blood; D010282:Parathyroid Neoplasms / Q000097:blood / Q000473:pathology* / Q000601:surgery; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D015415:Biomarkers; C470125:PTH protein, human; D010281:Parathyroid Hormone; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D017256:Technetium Tc 99m Sestamibi
Hyperparathyroidism; Neoplasm recurrence; Parathyroid neoplasms; Positron-emission tomography