Parathyroid carcinoma is a rare cause for primary hyperparathyroidism. A 65-yr-old man presented with postoperative, recurrent hyperparathyroidism after resection of parathyroid carcinoma. Misleading findings were demonstrated by both double-phase 99mTc-sestamibi scintigraphy and MRI. The location and extent of the parathyroid carcinoma were correctly detected by PET using 18F-fluorodeoxyglucose. FDG-PET provided accurate information before reoperation and proved to be valuable for preoperative surgical planning.

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