Marked uptake of technetium-99m pertechnetate by parathyroid adenoma

We herewith report an unusual case of primary hyperparathyroidism whose par athyroid adenoma strongly accumulated technetium (Tc)-99m pertechnetate, A 41-year-old woman was referred to our department under the tentative diagno sis of primary hyperparathyroidism. Scintigraphy by thallium-201 chloride s howed homogeneous uptake in the whole thyroid, whereas Tc-99m image reveale d a strong local accumulation in the middle portion of the right thyroidal lobe, Neck exploration revealed a 12x8x5-mm tumor in the posterolateral reg ion of the right thyroidal lobe, the pathology of which was parathyroid ade noma, In addition, a small nodule (g mm in diameter) with pathological find ings revealing follicular adenoma of the thyroid, was found within the medi al portion of the right thyroidal lobe, Both lesions were removed by surger y, and a postoperative Tc-99m scintigraphy no longer demonstrated a signifi cant uptake in the right thyroidal lobe, Since the thyroid adenoma was too small to be detected by any scintigraphic study and located much closer to the median line than the site of the marked accumulation of Tc-99m pertechn etate, it was considered very likely that the parathyroid adenoma concentra ted Tc-99m, Search of literature revealed that there have been only thirtee n cases of parathyroid tumor reported to date which significantly accumulat ed Tc-99m pertechnetate, The present patient represents another rare case o f parathyroid adenoma showing such an unusual scintigraphic image.