Medicina Nuclear e Radioterapia

Bone Metastasis from Parathyroid Carcinoma Non-avid for 99mTc-MIBI, 99mTc-MDP, and 18F-FDG

Abstract

Maomei Ruan, Yan Shen, Huizhen Zhang, Minghua Li and Libo Chen

Nuclear medicine imaging modalities have been reported to be useful in the diagnosis of parathyroid carcinoma (PC). However, false negative findings of bone metastasis from PC have been rarely reported. Here, we describe a patient undergoing nuclear medicine examinations since he had persistent high calcium and parathyroid hormone levels after resection of parathyroid tumor. 99mTc-Sestamibi (99mTc-MIBI) whole body scintigraphy (WBS) and 99mTc-methylene diphosphonate (99mTc-MDP) WBS were both negative. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18FDG-PET/CT) scan demonstrated osteolytic lesion in the fourth lumbar vertebrae (L4) on CT image with no obvious 18F-FDG accumulation on PET image. CT-guided fine needle aspiration and pathalogical examinations confirmed bone metastasis from PC.