ABSTRACT
Ectopic parathyroid adenomas are a common cause of postsurgical persistent primary hyperparathyroidism. Our case highlights a patient with a negative bilateral 4-gland exploration with follow-up parathyroid 4-dimensional CT and Tc-MIBI SPECT/CT, yielding focal uptake in the right piriform sinus. Subsequent direct laryngoscopy revealed a mass in the piriform sinus, which was resected with surgical pathology yielding parathyroid adenoma.
Subject(s)
Adenoma/diagnostic imaging , Four-Dimensional Computed Tomography , Parathyroid Neoplasms/diagnostic imaging , Pyriform Sinus/diagnostic imaging , Single Photon Emission Computed Tomography Computed Tomography , Technetium Tc 99m Sestamibi , Adenoma/surgery , Female , Humans , Male , Middle Aged , Parathyroid Neoplasms/surgeryABSTRACT
Primary carcinoma of the middle ear is extremely rare. A 41-year-old woman with a history of skull base osteomyelitis and chronic suppurative right otitis media presented with 1 month of right-sided facial droop, tearing, and headaches. Initial head CT revealed bony destruction and soft tissue opacification involving the right middle ear. Surgical biopsy yielded poorly differentiated carcinoma. Subsequent F-FDG PET/CT and MRI scans demonstrated FDG-avid soft tissue in the right middle ear with associated heterogeneously enhancing soft tissue on MRI.
