Parathyromatosis type 2 detected by 99m Tc-MIBI SPECT/CT

Parathyromatosis, which is defined as multiple foci of benign hyperfunctioning parathyroid tissue in neck or mediastinum, is a rare but severe cause of persistent/recurrent renal hyperparathyroidism (rHPT) after parathyroidectomy (PTX). It is hard to detect and remove all the foci. We present a case of parathyromatosis in a haemodialysed patient, who had three PTXs for persistent/recurrent rHPT and was free of recurrence during 31-month follow-up after the third PTX. Tc-99m-MIBI SPECT/CT scan prior to the third PTX located all the lesions. The presented case suggests that preoperative Tc-99m-MIBI SPECT/CT is useful for successful surgical removal of parathyromatosis.