This parathyroid scan following intravenous administration of Tc99 demonstrates immediate radiotracer uptake in salivary glands, heart, and thyroid lobes, as well as an area of uptake below the left thyroid lobe consistent with a parathyroid adenoma. At 2.5 hours, the activity in thyroid gland has washed out, and a second focus of activity appears inferior to the right lobe of thyroid, representing another parathyroid adenoma. Double adenomas represent less than 1% of cases of parathyroid adenoma.