HYPERPARATHYROIDISM SUPER SCAN
Male 49 year old, with hypertension, renal insufficiency,
under hemodyalisis, underwent parathyroidectomy (nov-2009). Biopsy showed
minimally invasive parathyroid carcinoma with angioinvation and focal
capsullar involvement. Follow up showed PTH elevation of 2287 pg/ml.
Note diffuse increased 99m Tc MDP uptake, including axial and apendicular bone,
skull and mandible. No activity in kidneys nor bladder.
(Prepared by Dr Isabel Berrocal)
The pattern of Super Scan can be seen in metabolic and metastatic disease. In
metabolic cases the involvement is more diffuse and includes the whole
skeleton, axial, apendicular, skull and mandible. On the other hand metastatic
super scan affects primarely axial bone with some focal and asymmetric uptake
areas and irregular activity.
1 Serrano J, et al. Reversible hyperparathyroid metabolic osteopathy
secondary to parathyroid carcinoma. Rev Esp Med Nucl. 1998; 17 (1): 35-9.
2 Mittra E., Segall G. Concurrent metabolic and osseous metastatic disease
on a Tc 99m- MDP bone scan. Eur J Nucl Med Mol Imaging. 2007; 34: 2150.
3 Buckley O., et al. 99mTc bone scintigraphy superscans: a review. Nucl Med
Commun. 2007; 28 (7): 521-7.