Localization of Parathyroid Disease in Reoperative Patients with Primary Hyperparathyroidism

Figure 7

Ectopic parathyroid adenoma on four-dimensional computed tomography (4DCT). A patient presents with recurrent hyperparathyroidism after prior total thyroidectomy with benign pathology and prior bilateral inferior parathyroidectomy. Axial precontrast 4DCT (a) shows ectopic adenoma (red arrow) in the right para-retroesophageal region almost at the prevertebral fascia, deep to right surgical clips (white arrows). The ectopic adenoma is hyperenhancing on axial postcontrast (b) and coronal (c) early arterial phases (red arrows).