Case Author(s): J. Wallis , 4/20/95 . Rating: #D4, #Q2

Diagnosis: Small parathyroid adenoma

Brief history:

Elevated serum calcium


(left) Initial 10 min images and (right) delayed images at 2 hrs. Below is shown an enlarged version of the delayed image.

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Full history/Diagnosis is available below

Diagnosis: Small parathyroid adenoma

Full history:

The study was obtained pre-operatively for localization of a parathyroid adenoma


Tc-99m Sestamibi


Normal clearance of tracer is seen from the thyroid gland. On initial images, the inferior right pole appears to extend slightly lower than the contralateral side.

On delayed images, there is subtle retension of tracer in this inferior right pole region.


This case is at the limit of resolution of the scintigraphic technique. Although this subtle a finding is not as definitive as would be seen with larger lesions, it can provide a starting point for the surgical exploration.


On surgical exploration, a 1.2 x 1.5 cm parathyroid adenoma was found at the inferior margin of the right lobe of the thyroid, corresponding to the scintigraphic findings.

ACR Codes and Keywords:

References and General Discussion of Parathyroid Scintigraphy (Anatomic field:Face, Mastoids, and Neck, Category:Metabolic, endocrine, toxic)

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Case number: pa003

Copyright by Wash U MO