Localization of Mediastinal Parathyroid Adenoma in Recurrent Postoperative Hyperparathyroidism With Tc-99m Sestamibi SPECT

The preoperative localization of abnormal parathyroid tissue in patients with persistent or recurrent hyperpara-thyroidlsm after previous surgical neck exploration has been a difficult diagnostic problem. As a complicating factor, approximately 20% of parathyroid glands are found in ectopic locations, the mediastinum being the most frequent of these sites. Recently, Tc-99m sestamibi has been reported to successfully detect and localize parathyroid adenomas preoperativeiy. In this patient with postoperative, recurrent hyperparathyroidism, Tc-99m sestamibi SPECT demonstrated abnormal focal accumulation in a mediastinal location, which correlated with a surgically proven parathyroid adenoma.