Gamma Probe Guided Ectopic Hyperplastic Parathyroid Gland Resection

The aim of this case report is to present an ectopically localized retrosternal hyperplastic parathyroid tissue which was resected successfully with the guide of gamma probe after localization by technetium 99m methoxyisobutylisonitril (Tc-99m MIBI) parathyroid scintigraphy. (Tc-99m-MIBI) parathyroid scintigraphy was performed for primary hyperparathyroidism in a forty nine-year-old male patient with a history of coronary artery disease. Scintigraphy depicted ectopic parathyroid tissue which was localized in the mediastinum inferior to the thyroid gland. Excision of the pathologic parathyroid tissue was planned in the same session of the coronary artery bypass surgery. During the operation day, 20 mCi Tc-99m MIBI was was injected 2 h before the operation. Lesion was found in substernal region with the guide of gamma probe in operation. Histopathological examination was reported as parathyroid hyperplasia and the levels of serum calcium and intact parathormone were returned to normal after surgery. With the help of Tc-99m-MIBI parathyroid scintigraphy and gamma probe guided parathyroid surgery, localization and surgical excision of ectopic parathyroid patholoiges is become easy.