Savaş KARYAĞAR, Sevda S. KARYAĞAR, Nalan ULUFİ, Tevfik ÖZPAÇACI, Enis YÜNEY

Surgical treatment of the Tc-99m sestamibi negative solitary parathyroid adenoma with radioguided occult lesion localization (ROLL) technique: Case report

Multinodüler guatr tanısı ile bilateral subtotal tiroidektomi operasyonu geçirmiş olan 75 yaşındaki bayan hasta primer hiperparatiroidizm ön tanısı ile paratiroid sintigrafisi çekilmek üzere kliniğimize yönlendirildi. Çift zamanlı paratiroid sintigrafisinde paratiroid adenomu ile uyumlu bulgu saptanmadı. Ultrasonografik (USG) değerlendirmede sağ tiroid lojunda, bakiye tiroid dokusunun üst kısmında 15 × 10 mm boyutunda hipoekoik yuvarlak lezyon izlendi. US eşliğinde ince iğne aspirasyon biyopsisi yapıldı. Histopatolojik değerlendirme paratiroid adenomu ile uyumlu idi. Operasyondan 16 saat önce USG eşliğinde 1mCi 99mTc-macro albumin aggregat lezyon içine enjekte edildi. Tc-99m sestamibi negatif soliter paratiroid adenomu radioguided occult lesion localization (ROLL) tekniği ile lokal anestezi altında cerrahi olarak çıkarıldı. Bu olgu, literatürde ROLL tekniği ile cerrahi eksizyon yapılan ilk Tc-99m sestamibi negatif soliter paratiroid adenomudur.

Tc-99m sestamibi negatif soliter paratiroid adenomunun ‘Radioguided occult lesion localization’ (ROLL) tekniği ile cerrahi tedavisi

A 75-year- old woman who had undergone bilateral subtotal thyroidectomy for multinodular goitre was referred to our clinic for parathyroid scintigraphy due to primary hyperparathyroidism. Dual phase 99mTc-sestamibi scintigraphy was negative for parathyroid adenoma. Ultrasonographic (USG) evaluation revealed a hypoecoic round lesion, located at the right thyroid bed and superior to the thyroid remnant, measuring 15 × 10 mm. US guided fine needle aspiration biopsy was performed. Histopathological findings were compatible with parathyroid adenoma. 1 mCi 99mTc-macro albumin aggregate was injected into the lesion under USG guidence 16 hours before the surgery. Radioguided occult lesion localization (ROLL) technique was applied for surgical excision of Tc99m sestamibi negative solitary parathyroid adenoma (SPA) under local anesthesia. In literature, this is the first report of using ROLL technique for surgical treatment of the 99mTc-sestamibi negative SPA.

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Turkish Journal of Nuclear Medicine (. Molecular Imaging and Radionuclide Therapy)-Cover

ISSN: 1304-1495
Yayın Aralığı: Yılda 4 Sayı
Başlangıç: 1992
Yayıncı: Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.