Sestamibi Localization of a Parathyroid Adenoma in the Presence of a Thymoma: a Case Report and Review of the Literature

Sestamibi Localization of a Parathyroid Adenoma in the Presence of a Thymoma: a Case Report and Review of the Literature

Preoperative localization in the surgical management of primary hyperparathyroidism is complicated by widely variable parathyroid gland anatomy, coexisting thyroid pathology, incidence of supernumerary and ectopic parathyroid glands, and limitations of targeted imaging studies. Technetium 99mTcsestamibi scans have decreased accuracy, sensitivity and specificity in the presence of multi-gland parathyroid disease. A number of reports suggest that thymomas, which also show increased sestamibi uptake, are potential sources of false positives on 99mTc-sestamibi scans. Herein, we describe a thymoma in association with a parathyroid adenoma complicating localization of hyperfunctional parathyroid tissue. We review the literature of concurrent pathology between parathyroid adenomas and thymomas paying particular attention to how these cases present on preoperative 99mTcsestamibi scans.