Abstract:Objective: To study the imaging manifestations of parathyroid carcinoma. Methods: Ultrasonography, 99mTc-MIBI SPECT/CT(or SPECT), MRI findings and 18F-FDG PET/CT of 6 patients with parathyroid carcinoma confirmed pathologically were analyzed retrospectively, and reviewing relevant literatures. Results: Ultrasonography findings: The average maximum diameter of 6 lesions was 27.7 mm; 6 cases manifested hypoechonic, 2 of which had mirocalcifications; 3 cases showed sharp in grey scale while 3 cases presented blurred nodular margin; 4 cases had a little blood flow while 2 cases with rich blood flow. 99mTc-MIBI SPECT/CT(or SPECT) findings: 3 cases were positive and 3 cases were negative; On CT imaging, 2 cases contained microcalcifications. On MRI, 1 case showed slight low signals on T1WI and slight hyperintensity signals on T2WI, and hyperintensity signal on T1-weighted sequence. One case of postoperative 18F-FDG PET/CT found intensely high FDG uptake in multiple bones(range of SUVmax: 2.5~8.8) with osteolytic destruction and soft tissue mass. Conclusion: The imaging findings of parathyroid carcinomas have certain features. Heterogeneous intensity, microcalcifications, blurred nodular marginare helpful for diagnosis of parathyroid carcinoma. MRI can clearly manifest the relationship between adjacent tissues. 18F-FDG PET/CT is contributed to restaging, evaluation of postsurgery and follow-up of parathyroid carcinoma.
萨 日,关 锋,代玉银,林承赫. 甲状旁腺癌的影像学表现(附6例报道并文献复习)[J]. 中国临床医学影像杂志, 2018, 29(8): 568-570.
SA Ri, GUAN Feng, DAI Yu-yin, LIN Cheng-he . Imaging manifestations of parathyroid carcinoma(6 cases and literature review). JOURNAL OF CHINA MEDICAL IMAGING, 2018, 29(8): 568-570.
[1]Cakir B, Polat SB, Kilic M, et al. Evaluation of preoperative ultrasonographic and biochemical features of patients with aggressive parathyroid disease: is there a reliable predictive marker?[J]. Arch Endocrinol Metab, 2016, 60(6): 537-544.
[2]刘赫,姜玉新,张缙熙. 甲状旁腺癌的声像图表现[J]. 中国医学影像技术,2004,20(12):1860-1861.
[3]刘方舟,董明敏,朱岩,等. 甲状旁腺占位性病变的临床分析[J]. 中华耳鼻喉头颈外科杂志,2009,44(4):282-286.
[4]Nam M, Jeong HS, Shin JH. Differentiation of parathyroid carcinoma and adenoma by preoperative ultrasonography[J]. Acta Radiol, 2017, 58(6): 670-675.
[5]Campennì A, Giovinazzo S, Pignata SA, et al. Association of parathyroid carcinoma and thyroid disorders: A clinical review[J]. Endocrine, 2017, 56(1): 19-26.
[6]季红,金常青,于建芳,等. 99mTc-MIBI诊断甲状旁腺癌1例[J]. 中国医学影像技术,2009,25(11):1999.
[7]Cetani F, Pardi E, Marcocci C. Update on parathyroid carcinoma[J]. J Endocrinol Invest, 2016, 39(6): 595-606.
[8]Gardner CJ, Wieshmann H, Gosney J, et al. Localization of metastatic parathyroid carcinoma by 18F FDG PET scanning[J]. J Clin Endocrinol Metab, 2010, 95(11): 4844-4845.
[9]Evangelista L, Sorgato N, Torresan F, et al. FDG-PET/CT and parathyroid carcinoma: Review of literature and illustrative case series[J]. World J Clin Oncol, 2011, 2(10): 348-354.
[10]Andersen KF, Albrecht-Beste E. Brown Tumors Due to Primary Hyperparathyroidism in a Patient with Parathyroid Carcinoma Mimicking Skeletal Metastases on (18)F-FDG PET/CT[J]. Diagnostics(Basel), 2015, 5(3): 290-293.
[11]Park SH, Kong GM, Kwon YU, et al. Pathologic Fracture of the Femur in Brown Tumor Induced in Parathyroid Carcinoma: A Case Report[J]. Hip Pelvis, 2016, 28(3): 173-177.
[12]Christakis I, Bussaidy N, Clarke C, et al. Differentiating Atypical Parathyroid Neoplasm from Parathyroid Cancer[J]. Ann Surg Oncol, 2016, 23(9): 2889-2897.