Octreotide uptake in parathyroid adenoma

Abstract

The patient with a history of bone pain and muscle weakness, was thought to have oncogenic osteomalacia as a result of biochemical investigations and directed to Nuclear Medicine Department for a whole-body bone scintigraphy and 111In-octreotide scintigraphy. There was no focal pathologic tracer uptake, but generalized marked increase in skeletal uptake on bone scintigraphy. Octreotide scintigraphy showed accumulation of octreotide in the region of the left lobe of the thyroid gland in the neck. Thereafter, parathyroid scintigraphy was performed with technetium-99m labeled metroxy-isobutyl-isonitryl (99mTc-MIB) and MIBI scan demonstrated radiotracer uptake at the same location with octreotide scintigraphy. The patient underwent left inferior parathyroidectomy and histopathology confirmed a parathyroid adenoma. Somatostatin receptor positive parathyroid adenoma may show octreotide uptake. Octreotide scintigraphy may be promising and indicate a possibility of using somatostatin analogues for the medical treatment of somatostatin receptor positive Conflict of interest:None declared.

Keywords: Parathyroid adenoma; indium-111-octreotide; somatostatin.

Figure 1. The generalized marked in skeletal uptake on anterior andposterior view of the whole-body bone scan (superscan appearance)

Figure 2. ¹¹¹In octreotide whole body scintigraphy revealed focaluptake at the localization of the left thyroid lobe in the neck

Figure 3. ^99mTc-MIBI (A)/⁹⁹Tc pertechhnetate (B) prathyroid imagingdemons intense MIBI retention in left lobe inferior of thyroid glandsupporting parathyroid aden

Figure 4. Parathyroid adenoma with formation of microfollicles(H&Ex 200) (A) and Somatostatin Ab-1 immunreactivity positive areasin parathyroid adenoma (IHCx400) (B)