Localization of Parathyroid Disease in Reoperative Patients with Primary Hyperparathyroidism

Figure 3

Ectopic mediastinal adenoma. A 56-year-old female presents with persistent hyperparathyroidism after prior four-gland parathyroidectomy and right thyroid lobectomy. Planar sestamibi scintigraphy at 20 minutes (a) and two hours (b) and coronal single-photon emission computed tomography (SPECT) (c) show a hypermetabolic mediastinal gland. Coronal (d) and axial (e) hybrid SPECT and computed tomography (SPECT/CT) confirm an ectopic and adenomatous fifth gland in the anterior mediastinum.

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