An interesting case of intrathyroidal parathyroid adenoma

Abstract

DESCRIPTIONIntrathyroidal parathyroid adenomas are an uncommon cause of primary hyperparathyroidism (PHPT) and their prevalence varies from 1.4% to 6%.1 2We present a case of a 42-year-old woman with residual PHPT, operated elsewhere, with localisation of parathyroid tumour on ultrasonography and sestamibi scintigraphy on the right side of the thyroid gland (figure 1). Review of the operative records revealed a search for the parathyroid tumour on the right side, along the eutopic sites of the superior and inferior parathyroids up to the innominate vein. Frozen section and histopathology revealed only normal parathyroids and the patient remained hypercalcaemic postoperatively.A few months later sestamibi scintigraphy was again performed with no change in the findings. Re-exploration did not reveal a tumour in the previously operated sites and hence the thyroid was carefully palpated and a nodule was felt in the right lobe of the thyroid. A hemithyroidectomy was performed and the cut section showed a parathyroid adenoma (1.7×0.9 cm) encircled by a rim of thyroid tissue confirming its intrathyroidal location (figure 2). Histopathology confirmed the same. Postoperatively the patient remained eucalcaemic.

Intra-thyroid parathyroid adenoma: a difficult task to find

“…The inferior parathyroid gland descends through the neck and down the thymus along an embryonic long virtual tract and the superior parathyroid gland descends through a shorter length compared to the inferior parathyroid gland. 7 In our case, it was an intrathyroidal parathyroid adenoma of the superior parathyroid gland.…”

An atypical concurrent occurrence of parathyroid adenoma and micropapillary thyroid carcinoma: First case reported in Saudi Arabia

“…In our patient, no significant findings as well were detected by ultrasound further supporting the lack of sensitivity provided by this imaging modality. Some studies however reported that a combination of SPECT/CT and ultrasonography can accurately localize intrathyroidal parathyroid adenomas [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] .…”

Co-occurrence of bilateral intrathyroidal parathyroid gland and papillary thyroid carcinoma; a case report

“…Such as parathyroid, thymus and lymph nodes [7] . Even though parathyroid adenomas or carcinomas inside the thyroid is far from uncommon [8] , [9] , the incidence of normal parathyroid gland embedded in the thyroid parenchyma is much scarcer with only a handful of cases [10] , [11] . Usually, in both of normal and tumorous ITP cases a solitary parathyroid nodule is imbedded inside the thyroid tissue, and so far, only 2 cases in the English literature have reported in which bilateral presence of parathyroid nodules on both sides of the thyroid gland was observed [4] , [12] .…”