Double-phase Tc-99m MIBI scintigraphy in secondary hyperparathyroidism relapsing after parathyroidectomy and removal of a parathyroid autograft.

A 53-year-old woman with chronic renal failure had secondary hyperparathyroidism relapsing after undergoing a second parathyroidectomy and excision of an autologous parathyroid graft that had been implanted after her first parathyroidectomy. Double-phase scintigraphy with Tc-99m MIBI disclosed pathologic MIBI uptake in the right anterior thorax where the parathyroid transplant had been placed. Histopathologic examination of three nodules excised from this region yielded hyperplastic parathyroid tissue. This case report further illustrates the value of double-phase Tc-99m MIBI scintigraphy in atypical cases of hyperparathyroidism.