Author(s)

Maria R. Alvarez¹, Rodrigo Arrangoiz², Miguel Ángel Olarte³, Cecilia Carreras⁴, Maria M. León S.³, Fernando Cordera²

¹Anahuac University, Huixquilucan, State of Mexico, Mexico.
²Sociedad Quirúrgica S.C. at the American British Cowdray Medical Center, Mexico City, Mexico.
³American British Cowdray Medical Center, Mexico City, Mexico.
⁴Hospital ángeles Lomas, Huixquilucan, State of Mexico, Mexico.

Primary hyperparathyroidism (PHPT) is a relative common medical problem caused by the inappropriate secretion of parathyroid hormone (PTH) by one or more parathyroid glands. The diagnosis is established by serum calcium and PTH levels and once the diagnosis is established imaging studies help localize the hyperfunctioning adenoma in preparation for curative surgery. Until now, the imaging studies most commonly utilized in PHPT are ultrasonography and ^99mTc-Sesta-methoxyisobutylisonitrile (MIBI) parathyroid scintigraphy. However, these studies often fail to localize the adenoma and inappropriately delay patient referral to a potentially curative surgery. We present the case of a 64-year-old female with symptomatic PHPT who had 3 negative ^99mTc-Sestamibi Scans over a period of 5 years who eventually had a PET/CT with ¹¹C-Choline that identified a right lower parathyroid adenoma. She underwent a right lower parathyroidectomy and had a successful outcome. We present a review the current imaging techniques used in the management of PHPT including ^99mTc-Sesta-MIBI scintigraphy and its limitations and novel use of PET/CT with ¹¹C-Choline and ¹⁸F-Choline in this disease and emphasize the fact that, according to current guidelines, failure to localize the adenoma should not delay referral for curative surgery.

Primary Hyperparathyroidism, Evaluation of Primary Hyperparathyroidism, ¹¹C-Choline, ¹⁸F-Fluorocholine, PET/CT, Treatment of Primary Hyperparathyroidism

Alvarez, M. , Arrangoiz, R. , Olarte, M. , Carreras, C. , León S., M. and Cordera, F. (2020) ¹¹C-Choline PET/CT in the Management of Primary Hyperparathyroidism. International Journal of Otolaryngology and Head & Neck Surgery, 9, 149-160. doi: 10.4236/ijohns.2020.95019.