My Imaging Results (Hyperparathyroidism)

[Madisons_Mommy]

Hi Dr. Lupo, me again!  

Here are my imaging results:

Thyroid Ultrasound, Jul 08: "There is suggestion of a possible RIGHT suprathyroid nodule.  It is difficult to tell whether this is a true finding.  If there is clinical suspicion of an enlarged parathyroid gland, then nuclear medicine study is recommended."

Parathyroid Sestamibi, Jul 08: "There is a subtle focus of mildly increased uptake seen approximately 1 cm below the LEFT lobe of the thyroid.  This remains on delay imaging, and could potentially represent a very mild parathyroid adenoma versus technetium in the vascular space likely of the distal jugular/subclavian vein."

Parathryoid Sestamibi, Aug 08: NEGATIVE

Parathyroid Sestamibi w/SPECT Imaging, Oct 08: "Uniform uptake throughout the thyroid on initial images with washout of sestamibi activity on the delayed images.  However, on the SPECT images there is a subtle mild anterior mediastinal focus of activity which may represent ectopic parathryoid adenoma.  Otherwise, no other concerning findings for additional foci of adenoma."

Neck MRI, Oct. 08: "7mm in diameter LEFT paratracheal mass seen inferior to the LEFT lobe of the thyroid which has increased T2 signal and enhances and may represent a small parathyroid adenoma."

SPECT/CT, Oct. 08: "Asymmetric uptake inferior to the LEFT lower pole of the thyroid may represent parathyroid hyperplasia, less likely parathyroid adenoma."

Like I said, since nothing "jumped" out at the docs (ENT) with all of these scans, they will not operate and almost refuse to believe the symtptoms I have (low energy, fatigue, mild acid reflux) correlate with the condition b/c they believe my Ca+ is at normal to high-normal levels.  What would you recommend I do next?  Should I just wait, then rescan?

Thank you again!!

[stella5349]

I understand there is a great site of information on parathyroid disease.

Have you viewed any of the information available on the parathyroid.com website?

[Mark Lupo, M.D.]

The diagnosis is made by labs -- not scans -- would recommend a university based evaluation if not already done (or Mayo Clinic).