Fig. 5.

Bilateral parathyroid adenoma in 21-year-old female with high serum calcium level. (a) USG neck with two hypoechoic nodules, one on the inferior aspect of left thyroid lobe with seperable hyperechoic line from thyroid tissue and increased vascularity inside on color Doppler (upper two images) and another one on the posterior aspect of middle part of right thyroid lobe with mild vascularity inside (lower two images). (b) Early images of Tc99 m sestamibi (upper two images) scan showed intense tracer uptake on the two nodules more marked on the one inferior to left thyroid lobe and along with uptake in both lobes of the thyroid gland and delayed images (lower two images) at 2 h show tracer retention with wash out from thyroid gland. (c) SPECT/CT imaging localizes the tracer uptake of both nodules more marked on that inferior to left thyroid lobe.