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FIGURE 6. Anatomic localization of ectopic parathyroid adenomas by 99mTc-sestamibi SPECT. (A) Patient with persistent hyperparathyroidism after total thyroidectomy and bilateral neck exploration performed because of concomitant multinodular goiter and PHPT. Tomographic slices in transverse (left), sagittal (center), and coronal (right) planes define anatomic location of single focus of intense 99mTc-sestamibi uptake in anterior planes of upper mediastinum. Minimally invasive reoperation under radioguidance enabled surgeon to remove parathyroid adenoma located within thymus. (B) Tomographic slices in transverse (1), sagittal (2), and coronal (3 and 4) planes define anatomic location of single focus of intense 99mTc-sestamibi uptake behind thyroid gland. Surgery revealed parathyroid adenoma located in retroesophageal space.
