USEFULNESS OF TECHNETIUM-99M-METHOXYISOBUTYLISONITRILE IMAGING AND INTRAOPERATIVE STAINING TECHNIQUE USING METHYLENE BLUE FOR LOCALIZATION : TWO CASES OF HYPERFUNCTIONING PARATHYROID LESIONS

Yoshio Horii; Yuichi Iino; Michio Maemura; Hiroyuki Takei; Jun Horiguchi; Yukio Koibuchi; Takao Yokoe; Noboru Oriuchi; Tomio Inoue; Keigo Endo; Tsunehiro Ishida; Yasuo Morishita

doi:10.2974/kmj.48.367

USEFULNESS OF TECHNETIUM-99M-METHOXYISOBUTYLISONITRILE IMAGING AND INTRAOPERATIVE STAINING TECHNIQUE USING METHYLENE BLUE FOR LOCALIZATION :

TWO CASES OF HYPERFUNCTIONING PARATHYROID LESIONS

Yoshio Horii, Yuichi Iino, Michio Maemura, Hiroyuki Takei, Jun Horiguchi, Yukio Koibuchi, Takao Yokoe, Noboru Oriuchi, Tomio Inoue, Keigo Endo, Tsunehiro Ishida, Yasuo Morishita

Author information

Yoshio Horii
Second Department of Surgery Gunma University School of Medicine
Yuichi Iino
Department of Emergency and Critical Care Medicine Gunma University School of Medicine
Michio Maemura
Second Department of Surgery Gunma University School of Medicine
Hiroyuki Takei
Second Department of Surgery Gunma University School of Medicine
Jun Horiguchi
Second Department of Surgery Gunma University School of Medicine
Yukio Koibuchi
Second Department of Surgery Gunma University School of Medicine
Takao Yokoe
Department of Emergency and Critical Care Medicine Gunma University School of Medicine
Noboru Oriuchi
Department of Nuclear Medicine, Gunma University School of Medicine
Tomio Inoue
Department of Nuclear Medicine, Gunma University School of Medicine
Keigo Endo
Department of Nuclear Medicine, Gunma University School of Medicine
Tsunehiro Ishida
Department of Surgery, Takasaki National Hospital
Yasuo Morishita
Second Department of Surgery Gunma University School of Medicine

Keywords: ^99mTc-MIBI, Hyperparathyroidism, Methylene blue staining, Ectopic parathyroid gland, Preoperative localization

JOURNAL FREE ACCESS

1998 Volume 48 Issue 5 Pages 367-371

DOI https://doi.org/10.2974/kmj.48.367

Details

Abstract

Two patients with primary hyperparathyroidism in whom it was difficult to search the location of abnormal parathyroid tissues are presented. Both patients, 35-year-old woman and 49-year-old man, had experienced several episodes of urolithiasis. A right lower (the former case) or right upper (the latter) parathyroid tumor was suspected by ultrasonography, but ²⁰¹Tl-Cl and ^99mTc-pertechnetate subtraction scintigraphy (TTSS) demonstrated no abnormal accumulation in the thyroid bed or mediastinum. At operation, no abnormal parathyroid gland was found in both patients. ^99mTc-methoxyisobutylisonitrile scintigraphy revealed the presence of elusive parathyroid lesion in the mediastinum or at the lower position of the left thyroid lobe. At reoperation, intraoperative staining with methylene blue was useful to find out the lesions in both patients. The histological diagnosis was hyperplasia of the parathyroid in both. The normal calcium level was obtained promptly after the removal of these tissues.

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