Introduction:

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.

Objective:

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.

Conclusions:

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.

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