Fig. 22

A 26-year-old male patient with elevated serum parathyroid hormones and calcium secondary to intra-thyroid parathyroid adenoma. a, b Enhanced axial and coronal CT scan of the neck demonstrate a well-defined hypodense right thyroid nodule (white arrows). c Bone window coronal CT scan shows lytic expansile lesions at the right mandible and left frontal bone (white arrows). d Transverse colour Doppler ultrasound of the neck demonstrates a well-defined, heterogonous, predominantly hypoechoic right thyroid nodule measuring 2.7 cm, with mild increased vascularity and no internal micro-calcifications (white arrow). e, f Delayed anterior planar and fused SPECT/CT parathyroid Sestamibi scan at 2 hours demonstrate persistent focal activity in the right thyroid lobe (white arrows). Note the scattered mandibular/maxillary uptakes in planar image representing the known brown tumours