Positron emission tomography, combined with computed tomography with 18F-fluorocholine in topical diagnosis of parathyroid glands tumors and secondary changes in bone tissue in hyperparathyroid osteodystrophy. Two clinical observations.

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Abstract

Primary hyperparathyroidism (PHPT) in 1% of cases is caused by parathyroid carcinoma (PC). The outcomes of the PC depend on quantitative processing and adequacy of the initial surgery.

A major difficulty is to differentiate PC metastasis in bones from hyperparathyroid osteodystrophy.

This article describes clinical cases of patients with severe form of PHPT accompanied by hyperparathyroid osteodystrophy, that was suspected to be cancer metastasis. The positron emission tomography combined with computed tomography (PET/CT) with 18F-fluorodeoxyglucose (18F-FDH) and/or 18F-fluorocholine was included in the algorithm of the examination. The histological examination of postoperative material confirmed benign tumors of the PG in both patients, and bone lesions detected during PET/CT were assessed as hyperparathyroid osteodystrophy. 

Accumulation of 18F-fluorocholine in bone destruction areas does not allow to differentiate hyperparathyroid osteodystrophy from metastases. In both cases, the accumulation of 18F-fluorocholine was detected only in the tumor.

About the authors

Natalia Mokrysheva

Endocrinology Research Centre 

Email: nm70@mail.ru
ORCID iD: 0000-0002-9717-9742
SPIN-code: 5624-3875

MD, PhD, Professor, head of Parathyroid Glands Pathology Department, Endocrinology Research Centre 

Russian Federation, 117036, Russia, Moscow, 11 Dm.Ulyanova street

Julia Krupinova

Endocrinology Research Centre 

Author for correspondence.
Email: krupinovaj@gmail.com
ORCID iD: 0000-0001-7963-5022
SPIN-code: 6279-8247

MD, researcher at Parathyroid Glands Pathology Department,  Endocrinology Research Centre 

Russian Federation, 117036, Russia, Moscow, 11 Dm.Ulyanova street

Mikhail Dolgushin

Blokhin Russian Cancer Research Center

Email: mdolgushin@mail.ru
ORCID iD: 0000-0003-3930-5998

MD, PhD, Professor, head of the Department of Positron Emission Tomography, Blokhin Russian Cancer Research Center 

Russian Federation, 115478, Russia, Moscow, 23 Kashirskoe Shosse

Akgul Odzharova

Blokhin Russian Cancer Research Center 

Email: odzharova07@yandex.ru
ORCID iD: 0000-0003-3576-6156
SPIN-code: 1074-3862

MD, researcher at the Department of Positron Emission Tomography, Blokhin Russian Cancer Research Center 

Russian Federation, 115478, Russia, Moscow, 23 Kashirskoe Shosse

Iya Voronkova

Endocrinology Research Centre

Email: iya-v@yandex.ru
ORCID iD: 0000-0001-6687-3240
SPIN-code: 9685-1371

MD, patomorphologist at Parathyroid Glands Pathology Department, Endocrinology Research Centre 

Russian Federation, 117036, Russia, Moscow, 11 Dm.Ulyanova street

Valeriy Voskoboynikov

Endocrinology Research Centre 

Email: vall_nat@rambler.ru
SPIN-code: 8438-8887

MD, surgeon at the Department of Endocrine Surgery, Endocrinology Research Centre

Russian Federation, 117036, Russia, Moscow, 11 Dm.Ulyanova street

Nikolaj Kuznecov

Endocrinology Research Centre

Email: surgery@endocrincentr.ru
ORCID iD: 0000-0002-9947-9511
SPIN-code: 8412-1098

MD, PhD, Professor, head of the Department of Endocrine Surgery, Endocrinology Research Centre

Russian Federation, 117036, Russia, Moscow, 11 Dm.Ulyanova street

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Copyright (c) 2021 Mokrysheva N., Krupinova J., Dolgushin M., Odzharova A., Voronkova I., Voskoboynikov V., Kuznecov N.

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