Co-existent Parathyroid Adenoma and Thyroid Carcinoma

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Abstract
Dual tracer parathyroid imaging (DTPI) using Tc-99m and Tl-201 has a reported sensitivity of 92% for the detection of parathyroid adenomas. A patient with biopsy-proven parathyroid adenoma as well as papillary thyroid carcinoma is presented. The diagnosis of primary hyperparathyroidism has recently been established more frequently than in the past due to detection of elevated serum Ca levels on routine blood samples, relatively sensitive parathormone (PTH) assays, and noninvasive imaging modalities such as nuclear medicine, CT [computed tomography] scanning, and ultrasonography. The location of parathyroid adenomas has been detected in many cases, using the dual tracer method with Tl-201 and Tc-99m, confirmed at surgery. A case of primary hyperparathyroidism is presented in which 2 distinct lesions were detected by nuclear imaging; 1 lesion was proven at surgery to be a parathyroid adenoma, while the other represented thyroid carcinoma.