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Intravenous digital subtraction angiography (DSA) successfully localized three previously suspected parathyroid adenomas in the lower part of the neck and one in the mediastinum. Our experience suggests that this method may have widespread application for preoperative evaluation of parathyroid adenomas, particularly after unsuccessful surgical exploration or when recurrent or ectopically located adenomas are likely. In three other cases abnormal vascular blushes in the neck on intravenous DSA were related to thyroid disease. Close correlation with the clinical and laboratory findings is necessary to avoid potential pitfalls in diagnosis.

Recognition of the clinically significant incidental lesion has always been a challenge to the diagnostic radiologist. We present a series of such lesions discovered in patients undergoing intravenous digital subtraction angiography (DSA). The increasingly widespread use of DSA and the subsequent large numbers of patients involved will no doubt result in a substantial number of cases of this type.

Our case emphasizes the complex nature of signal abnormalities observed with MRI and underscores that a given histopathologic lesion (such as craniopharyngioma) may have variable appearances upon imaging with this modality.

We report a case of renal cell carcinoma metastatic to the pituitary gland. A review of the literature indicated breast carcinoma to be the most frequent primary tumor metastatic to this site, while renal cell carcinoma metastasis has not been reported previously. This case emphasizes the capricious nature of renal cell carcinoma, particularly in a patient presenting with no evidence of disseminated disease.