technetium-tc-99m-medronate and Hyperparathyroidism--Primary

Metastatic pulmonary calcification (MPC) is rarely reported in primary hyperparathyroidism, especially MPC develops quickly. We report such a case here with a literature review.. A 41-year-old woman presented with cough and dyspnea. Data from clinical, radiological, pathological, technetium (. Rapidly progressive MPC tends to be misdiagnosed as many primary pulmonary diseases.

Topics: Adenoma; Adult; Calcinosis; Disease Progression; Female; Humans; Hyperparathyroidism, Primary; Image-Guided Biopsy; Lung Diseases; Parathyroid Neoplasms; Parathyroidectomy; Positron-Emission Tomography; Radiopharmaceuticals; Technetium Tc 99m Medronate; Technetium Tc 99m Sestamibi; Tomography, X-Ray Computed; Treatment Outcome

Metastatic pulmonary calcification (MPC) is an uncommon entity resulting from abnormalities in calcium-phosphorus homoeostasis. Most cases reported in the literature are among patients with chronic kidney disease receiving haemodialysis. Primary hyperparathyroidism is a relatively common condition affecting calcium homoeostasis, in which MPC can rarely occur. We report the case of one such patient who presented with severe hypercalcaemia and features of interstitial lung disease. Radiographic imaging was normal and the diagnosis was clinched by diffuse pulmonary uptake in

Topics: Adult; Calcinosis; Dyspnea; Female; Humans; Hyperparathyroidism, Primary; Parathyroidectomy; Radionuclide Imaging; Technetium Tc 99m Medronate; Treatment Outcome; Vomiting

Topics: Alkaline Phosphatase; Humans; Hypercalcemia; Hyperparathyroidism, Primary; Male; Middle Aged; Osteitis Deformans; Pelvic Bones; Radiography; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Vitamin D Deficiency

The purpose of this study was to assess the relationship between (99m)Tc-MIBI and (99m)Tc-MDP bone scintigraphy and clinical or pathological variables, including preoperative serum PTH levels and tumor diameter, in patients with newly diagnosed PHPT.. Dual-phase (99m)Tc-MIBI planar scintigraphy was performed in 244 patients with PHPT. Of these patients, 155 underwent (99m)Tc-MDP bone scintigraphy to detect bone changes before parathyroidectomy. Factors influencing (99m)Tc-MIBI scintigraphy and (99m)Tc-MDP bone scintigraphy detection rate were assessed using univariate and multivariate logistic regression analysis; optimal cutoff values for predicting positive (99m)Tc-MIBI and (99m)Tc-MDP bone scintigraphy were evaluated using ROC analysis.. Among 244 patients, 174 (71.31 %) patients with 181 foci had a positive (99m)Tc-MIBI planar scintigraphy; delayed neck and thorax SPECT/CT could identify and locate the (99m)Tc-MIBI lesions but could not find more lesions than planar scintigraphy. 70 (28.69 %) patients had a negative (99m)Tc-MIBI planar scintigraphy. Tumor diameter, serum PTH level and symptoms were statistically significant predictive factors in predicting positive (9m)Tc-MIBI scintigraphy both univariate and multivariate logistic regression analyses. The optimal thresholds for tumor diameter and serum PTH by ROC analysis were 1.03 cm and 127.60 ng/L, respectively. Among 155 patients with bone scintigraphy, (99m)Tc-MDP bone scintigraphy showed positive finding in 80 (51.61 %) patients and negative finding in 75 patients. Univariate logistic regression analysis showed that patient age, sex, tumor diameter and PTH level (≥150 ng/L) were statistically significant in predicting positive (99m)Tc-MDP bone scintigraphy. Multivariate logistic regression analysis showed both tumor diameter and PTH ≥ 150 ng/L were statistically significant in predicting positive (99m)Tc-MDP bone scintigraphy. The optimal thresholds for tumor diameter and serum PTH by ROC analysis were 1.96 cm and 163.85 ng/L, respectively.. The utility of delayed neck and thorax SPECT/CT over dual-phase (99m)Tc-MIBI planar scintigraphy is that it can identify and locate a parathyroid tumor in about more than 70 % of patients in PHPT and provide the assistance for surgical planning. These studies also suggest that (99m)Tc-MIBI scintigraphy and (99m)Tc-MDP bone scintigraphy are closely correlated with tumor diameter and PTH; which may show negative results when tumor diameter is small and serum PTH level is low.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Bone and Bones; Child; Female; Humans; Hyperparathyroidism; Hyperparathyroidism, Primary; Male; Middle Aged; Multivariate Analysis; Neck; Parathyroid Hormone; Parathyroid Neoplasms; Predictive Value of Tests; Retrospective Studies; ROC Curve; Technetium Tc 99m Medronate; Technetium Tc 99m Sestamibi; Thorax; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed; Treatment Outcome; Vitamin D; Young Adult

Paget disease of bone (PDB) and hyperparathyroidism (HPT) are metabolic osseous disorders which affect ≥2% of the population. As these diseases may share clinical, radiographic, biochemical, and histopathologic features, knowledge of their phenotypic overlap may provide diagnostic utility and improve clinical outcome. Scant information is available in the dental literature regarding patients concurrently affected with both pathologies. We present an unusual case report of a 63-year-old woman coaffected with primary HPT, attributed to a functional oxyphilic parathyroid adenoma, and PDB. Bone scintigraphy revealed pagetoid lesions of the skull, humeral head, spine, sacrum, and hemipelvis. Salient craniofacial features noted were bony involvement of the calvarium and midface, resulting in extensive maxillary overgrowth, hearing loss, telecanthus and consequent visual impairment, nasal deformity, and leontiasis ossea. The patient underwent a partial parathyroidectomy and bisphosphonate administration was to be initiated upon extraction of the remaining dentition.

Topics: Adenoma; Female; Humans; Hyperostosis; Hyperostosis Frontalis Interna; Hyperparathyroidism, Primary; Hypertelorism; Maxillary Diseases; Middle Aged; Nose Deformities, Acquired; Osteitis Deformans; Parathyroid Neoplasms; Parathyroidectomy; Radionuclide Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate