Document Type: Case Report
Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
Metabolic Syndrome Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Cardiothoracic Surgery and Transplant Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Primary hyperparathyroidism (pHPT) is defined by the excess level of parathyroid hormone (PTH). Parathyroid adenoma is responsible for about 80% of all pHPT. Parathyroid adenoma with cystic feature and atypical pathology is recognized as a rare entity. Technetium-99m methoxy isobutyl isonitrile ([99mTc]Tc-MIBI) scintigraphy has favorable detection rate for ectopic gland as well as the brown tumors. SPECT/CT plays critical role in localizing abnormal tracer uptake. Herein, we report a severely hypercalcemic patient with cystic atypical parathyroid adenoma and mediastinal uptake, which was confined to a sternal lytic lesion (suggestive of brown tumor), which highlights the importance of SPECT/CT in [99mTc]Tc-MIBI imaging.