Recurrent hyperfunctioning parathyroid gland demonstrated on radionuclide imaging and an intraoperative gamma probe

Radionuclide imaging with Tc-99m MIBI is the preferred mode of parathyroid localization in current practice. It also successfully identifies hyperfunc tioning autotransplanted parathyroid tissue. The authors report a case with recurrent hyperparathyroidism after total parathyroidectomy and autotransp lantation in the forearm. Double-phase Tc-99m MIBI imaging successfully loc alized the hyperfunctioning parathyroid tissue, which was missed by magneti c resonance imaging and ultrasonography. In addition, the parathyroid tissu e was localized using an intraoperative probe at subsequent surgery.