Use of a Technetium99m-Sestamibi Scan to Detect Ipsilateral Double Adenoma in a Patient with Primary Hyperparathyroidism: A Case Report.

INTRODUCTION: Patients with primary hyperparathyroidism generally have a single parathyroid adenoma that causes excessive excretion of parathyroid hormone. For about 2% to 15% of these patients, a double adenoma is present that involves one lesion on each side of the neck.

CASE PRESENTATION: We describe a case of double parathyroid adenoma causing asymptomatic hypercalcemia. A presurgical technetium99m (Tc99m) sestamibi scan suggested an ipsilateral double adenoma in the left thyroid lobe. An intraoperative parathyroid hormone assay confirmed its successful removal.

DISCUSSION: Although double adenomas are not yet widely acknowledged, presurgical imaging and nuclear scans can help to localize multiple lesions, and intraoperative parathyroid hormone assays can confirm the diagnosis and cure.