This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Tublin, M. E. Articles by Carty, S. E. Search for Related Content PubMed PubMed Citation Articles by Tublin, M. E. Articles by Carty, S. E.

Recurrent Hyperparathyroidism Secondary to Parathyromatosis

Clinical and Imaging Findings

Departments of Radiology (M.E.T.) and Surgery (J.H.Y., S.E.C.), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania USA.

Address correspondence to Mitchell E. Tublin, MD, Department of Radiology, University of Pittsburgh Medical Center, 200 Lothrop St, Suite 3950 CHP/MT, Pittsburgh, PA 15213 USA. E-mail: tublinme{at}upmc.edu

Objective. Parathyromatosis, a condition in which hyperfunctioning parathyroid tissue is distributed throughout the neck, is a rare but challenging cause of recurrent hyperparathyroidism after parathyroidectomy. The purpose of this series is to describe the imaging appearance of parathyromatosis and the potential utility of sonographic localization before resection. Methods. Imaging is routinely performed in an attempt to identify autonomous residual parathyroid glands in patients with recurrent hyperparathyroidism after parathyroidectomy. The sonographic and technetium Tc 99m sestamibi studies and the clinical records of 2 patients with recurrent hyperparathyroidism secondary to parathyromatosis were reviewed. Results. Color Doppler sonography easily identified scattered deep and superficial hypoechoic, hypervascular cervical nodules that did not conform to typical anatomic locations of parathyroid glands; the nodules corresponded to areas of delayed tracer uptake at Tc 99m sestamibi single-photon emission computed tomography. Intraoperative mapping of nodules aided the successful resection of widespread parathyromatosis in 1 patient. Conclusions. Although the sonographic appearance of parathyromatosis may mimic disseminated cervical malignancy, a confident diagnosis of this rare entity may be made in the appropriate clinical setting. Sonography may also aid in directing the resection of disseminated parathyroid tissue in selected patients.

Key Words: head and neck • hyperparathyroidism • parathyroid

Abbreviations: CT, computed tomographic • PTH, parathyroid hormone • SPECT, single-photon emission computed tomographic