A Case of Completely Intrathyroidal Parathyroid Adenoma Detected by Hypercalcemia despite Treatment with Denosumab

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  • デノスマブ投与でも高Ca血症が継続した甲状腺内完全埋没型副甲状腺腫の1例
  • 症例 デノスマブ投与でも高Ca血症が継続した甲状腺内完全埋没型副甲状腺腫の1例
  • ショウレイ デノスマブ トウヨ デモ コウCa ケッショウ ガ ケイゾク シタ コウジョウセン ナイ カンゼン マイボツガタ フクコウジョウセンシュ ノ 1レイ

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Abstract

We treated a case of intrathyroidal parathyroid adenoma which was detected by ultrasonography and 99mTc-sestamibi scintigraphy. The patient was a 70-year-old female who had received treatment with a bisphosphonate for osteoporosis and been initiated on denosumab. At one of her visits, blood tests revealed hypercalccemia and increased serum level of intact-PTH. Ultrasonography showed a hypoechoic mass in the right lobe of the thyroid gland, which we suspected was a parathyroid adenoma. 99mTc-sestamibi scintigraphy revealed increased accumulation of the radionuclide in the right lobe of the thyroid gland. We detected the parathyroid adenoma in the right lobe of the thyroid gland, and excised the tumor from the thyroid gland. After the operation, the serum calcium and serum intact-PTH decreased rapidly. Histopathology revealed an ectopic intrathyroidal parathyroid adenoma. Non-invasive examinations, including ultrasonography, and 99mTc-sestamibi scintigraphy can prove to be important aids in the diagnosis of ectopic parathyroid glands.

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