The patient is a 25 -year-old female with a history of primary hyperparathyroidism, post parathyroidectomy 5 years ago and autologous transplantation of remaining parathyroid gland from neck to left forearm 3 years ago, and persistent hyperparathyroidism. She is referred to evaluate for parathyroid adenoma.

Delayed images demonstrate near complete tracer washout from the thyroid and forearm musculature. However, in the region of the left forearm there is a persistent large focus of tracer uptake.

The focus of persistent uptake in the left forearm is consistent with parathyroid adenoma.