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Revista Cubana de Medicina

Print version ISSN 0034-7523On-line version ISSN 1561-302X


INFANTE-AMOROS, Adalberto et al. Primary hyperparathyroidism due to negative scintigraphy adenoma. Rev cubana med [online]. 2020, vol.59, n.3, e1324.  Epub Nov 10, 2020. ISSN 0034-7523.


Hyperparathyroidism is one of the most frequent causes of hypercalcemia. 85% of patients are older than thirty years, its highest frequency is over 60 years, in the long term it can produce a series of complications.


To describe a clinical case of primary hyperparathyroidism that was negative in the scintigraphy study with ectopic location of the adenoma.

Clinical case report:

A 20-year-old female patient with a 7-year history of renal and urethral lithiasis, who had undergone 13 lithotripsy sessions and two recurrent kidney surgeries. Six months ago, elevated calcium levels were detected. A study protocol for hypercalcemia was carried out, determining primary hyperparathyroidism. Ultrasound and neck tomography report a lesion that could correspond to a paratracheal parathyroid adenoma; however, methoxy-isobutylisonitrile and technetium-99 scintigraphy was negative. Conventional neck surgery was performed since radioguided surgery was not useful for locating the intraoperative parathyroid adenoma. Histopathological study reported parathyroid adenoma.


In parathyroid adenomas with negative scintigraphy, the diagnosis can be reached with conventional imaging studies. The ectopic location of the parathyroid adenoma is a cause of negative scintigraphy. Radioguided surgery is not helpful in scan-negative ectopic parathyroid adenomas.

Keywords : hyperparathyroidism; scintigraphy; parathyroid adenoma; hypercalcemia.

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