title: Osteosclerotic and osteolytic manifestations of hyperparathyroidism in a case of Tc99m SestaMIBI positive parathyroid adenoma.
abstract: Primary hyperparathyroidism is the first differential diagnosis when a patient presents with asymptomatic hypercalcemia. The symptoms of hyperparathyroidism can be as grave as skeletal, cardiovascular, and neuropsychological changes. Skeletal manifestations are relatively common, and patient may present with generalized or focal bone pains, fragility fractures, subperiosteal bone resorption, and osteolytic lesions like brown tumors and salt and pepper appearance of the skull. However, focal osteosclerotic lesions of the skull are rare findings in hyperparathyroidism. Only a few cases of associated osteosclerosis are reported in the literature. Here, we report a case of Tc99m SestaMIBI positive parathyroid adenoma with coexisting osteolytic and osteosclerotic skull lesions on Tc99m methylene diphosphonate bone scan.
authors.affiliation: Department of Nuclear Medicine, VMMC and Safdarjung Hospital, New Delhi, India.
authors.forename: Kalpa Jyoti
authors.initials: KJ
authors.lastname: Das
authors.affiliation: Department of Nuclear Medicine, VMMC and Safdarjung Hospital, New Delhi, India.
authors.forename: Aditi Khurana
authors.initials: AK
authors.lastname: Sehgal
authors.affiliation: Department of Orthopaedics, VMMC and Safdarjung Hospital, New Delhi, India.
authors.forename: Ashish
authors.initials: A
authors.lastname: Jaiman
authors.affiliation: Department of Nuclear Medicine, VMMC and Safdarjung Hospital, New Delhi, India.
authors.forename: Ravinder Singh
authors.initials: RS
authors.lastname: Sethi
keywords: Brown tumor; Tc99m SestaMIBI; methylene diphosphonate bone scan; osteosclerotic skull lesion; parathyroid adenoma; primary hyperparathyroism