TC-99M SESTAMIBI IMAGING OF BROWN TUMORS OF PRIMARY HYPERPARATHYROIDISM

Double-phase scintigraphy using Tc-99m sestamibi MIBI is the study of choice for detecting parathyroid adenoma in patients with primary hype rparathyroidism. However, before parathyroid imaging, these patients m ay uncommonly present with multiple osteolytic lesions and bone scan f indings consistent with metastatic disease, By excluding malignancy, t he diagnosis of osteitis fibrosa cystica and parathyroid adenoma may s ubsequently be confirmed, The authors describe the case of an elderly patient who presented with imaging findings initially masquerading as metastatic disease, When parathyroid adenoma was finally diagnosed wit h Tc-99m MIBI imaging, radiopharmaceutical uptake was also noted withi n several brown tumors, including clinically significant brown tumors of the left lower extremity, a finding that has not been previously re ported.