Rubello D, Toniato A, Pelizzo M R, Casara D
Service of Nuclear Medicine, Regional Hospital and University of Padova, Italy.
Clin Nucl Med. 2000 Nov;25(11):898-900. doi: 10.1097/00003072-200011000-00008.
Two cases of papillary thyroid carcinoma coexisting with a parathyroid adenoma are reported. A double-tracer pertechnetate-MIBI subtraction scan combined with neck ultrasound correctly visualized the site of the parathyroid adenoma despite the presence of thyroid nodule(s) located in the opposite thyroid lobe in one case and in both thyroid lobes in the other case. In both patients, the papillary thyroid carcinoma was cold with Tc-99m pertechnetate and hot with MIBI. Total thyroidectomy and parathyroidectomy of a solitary parathyroid adenoma were performed in both patients. Pertechnetate-MIBI subtraction scanning associated with neck ultrasound appears to be a useful imaging technique to detect parathyroid adenoma before operation in patients with concomitant thyroid nodular disease. A MIBI-hot and Tc-99m pertechnetate-cold thyroid nodule can indicate the possible presence of a malignant lesion.
报告了2例甲状腺乳头状癌合并甲状旁腺腺瘤的病例。尽管1例患者的对侧甲状腺叶及另1例患者的双侧甲状腺叶存在甲状腺结节，但高锝酸盐 - MIBI双示踪剂减影扫描联合颈部超声正确显示了甲状旁腺腺瘤的位置。在这2例患者中，甲状腺乳头状癌对99mTc高锝酸盐呈冷结节，对MIBI呈热结节。2例患者均行了全甲状腺切除术及单个甲状旁腺腺瘤切除术。高锝酸盐 - MIBI减影扫描联合颈部超声似乎是一种在伴有甲状腺结节性疾病的患者术前检测甲状旁腺腺瘤的有用成像技术。MIBI热结节及99mTc高锝酸盐冷结节可能提示存在恶性病变。
