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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
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Abstract titles should be brief and reflect the content of the abstract.
Despite advancements in imaging and surgical techniques, persistent or recurrent secondary hyperparathyroidism (SHPT) remains relatively common. The primary objective of preoperative imaging is to identify all sources of excess parathyroid hormone secretion. However, physiologic parathyroid glands—typically small, approximately 5 × 3 × 1 mm—are often difficult to visualize. With increasing life expectancy, we hypothesize that postoperative imaging follow-up to detect residual physiologic parathyroid glands, previously missed on imaging, is essential for the long-term management of hemodialysis (HD) patients.
We report a 46-year-old woman with stage 5 chronic kidney disease for 10 years, followed by another 10 years of long-term hemodialysis. She developed recurrent secondary hyperparathyroidism 11 years after undergoing subtotal parathyroidectomy, attributed to a Technetium 99m sestamibi single photon emission computed tomography and computed tomography (Tc-99m-MIBI SPECT/CT)-negative ectopic paratracheal parathyroid gland.
During the pre-dialysis period, one year before hemodialysis started, she underwent subtotal parathyroidectomy to remove the enlarged bilateral inferior parathyroid glands. No enlarged parathyroid glands were identified at the upper poles of the bilateral thyroid lobes during surgery. However, the preoperative Tc-99m-MIBI SPECT/CT failed to detect an ectopic paratracheal parathyroid gland (Figure 1, blue arrows), which caused recurrent secondary hyperparathyroidism (SHPT) eleven years later. On preoperative computed tomography (CT) scan, the ectopic paratracheal parathyroid gland appeared to be of normal size and resembled a typical lymph node (Figure 2, yellow arrow). This paratracheal parathyroid was revealed by repeated Tc-99m-MIBI SPECT/CT (Figure 3) and confirmed histologically via endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) (Figure 4). Due to the complexity of surgical intervention, the patient was started on calcimimetic therapy.
While ectopic parathyroid adenomas were common in recurrent SHPT, physiologic uptake on initial 99mTc-MIBI SPECT/CT imaging did not indicate pathology. Therefore, repeat 99mTc-MIBI SPECT/CT imaging was essential for detection in our case.
