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Technetium-99m MIBI Uptake in Recurrent Parathyroid Carcinoma and Brown Tumors

Peking Union Medical College, Beijing, China
Department of Veterans Affairs Medical Center, and University of Kentucky Medical Center, Lexington, Kentucky

Correspondence: For correspondence or reprints contact: Wei-Jen Shih, MD, Nuclear Medicine Service, Department of Veterans Affairs Medical Center, Lexington, KY 40511.

ABSTRACT

Demonstrable parathyroid adenoma in delayed (3-hr) ^99mTc-MIBI neck imaging and localization of ²⁰¹Tl-chloride in brown tumors mimicking skeletal metastases have been reported. Technetium-99m-MIBI scintigraphy is currently the imaging modality of choice for localizing parathyroid tumors in patients with recurrent hyperparathyroidism. This report is a good example of the use of ^99mTc-MIBI in the diagnostic work-up of a patient with recurrent hyperparathyroidism, which turned out to be due to parathyroid carcinoma rather than the initial histopathologic diagnosis of parathyroid adenoma. Additionally, the patient's total body ^99mTc-MIBI and ^99mTc-MDP bone images showed multiple focal lesions in the bone-mimicking metastases.

Key Words: parathyroid carcinoma • brown tumors • technetium-99m-MIBI • double-phase imaging • hyperparathyroidism • technetium-99m-MDP • bone imaging

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