DOUBLE-PHASE TC-99M MIBI SCINTIGRAPHY IN SECONDARY HYPERPARATHYROIDISM RELAPSING AFTER PARATHYROIDECTOMY AND REMOVAL OF A PARATHYROID AUTOGRAFT

A 53-year-old woman with chronic renal failure had secondary hyperpara thyroidism relapsing after undergoing a second parathyroidectomy and e xcision of an autologous parathyroid graft that had been implanted aft er her first parathyroidectomy. Double-phase scintigraphy with Tc-99m MIBI disclosed pathologic MIBI uptake in the right anterior thorax whe re the parathyroid transplant had been placed. Histopathologic examina tion of three nodules excised from this region yielded hyperplastic pa rathyroid tissue. This case report further illustrates the value of do uble-phase Tc-99m MIBI scintigraphy in atypical cases of hyperparathyr oidism.