PMC7402866_01
MIBI-Technetium subtraction scintigraphy, with evidence of left inferior parathyroid tracer uptake.
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The patient followed up routinely until 2018, when neck ultrasonography for relapsing hyperparathyroidism revealed an adenoma in the left inferior parathyroid, confirmed by technetium (99mTc) Sestamibi scintigraphy (Figure 1).
Histopathology of resected medullary thyroid cancer (MTC). Microscopically, it revealed polygonal cells with pale cytoplasm surrounded by fibrosis, collagen and amyloid tissue. H&E staining, (A). On immunohistochemistry, MTC was positive for Chromogranin (B), and CEA (C), and slightly positive for calcitonin (D). Magnification 40x (A); 100x (B); 200x (C and D).
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On immunohistochemistry (Leica Bond system; Bond-III; Leica Microsystems, Milan, Italy), the medullary tumor showed positive reactions to Chromogranin A and carcinoembryonic antigen (CEA) and was slightly reactive to Calcitonin; Ki67 expression was low (<5%) (Figure 2A-D).