Sestamibi uptake in brown tumor simulating a lung mass.

Abstract

A 28-year-old man with severe secondary hyperparathy-roidism and on hemodialysis for 11 years underwent a Tc-99m sestamibi study for preoperative localization of hyperfunctioning parathyroid glands. Laboratory data included a serum calcium of 10.8 mg/100 mL and a parathormone level of 1722 pg/mL. There were no palpable neck masses. In addition to bilateral localization of hyperplastic parathyroid glands, the scintigram showed an intense focus of uptake in the left hemithorax, suggesting a lung mass. Radiographic correlation revealed the MIBI uptake to be in a large expansile lytic lesion of the second rib consistent with a brown tumor.