A Rare Case of Intrathyroid Parathyroid Adenoma: Diagnosis and Treatment
Ranjitha R. Maiyya *
Department of General Surgery, Grant Government Medical College and Sir J.J. Group of Hospitals, Mumbai, India.
Mahendra S. Navare
Department of General Surgery, Grant Government Medical College and Sir J.J. Group of Hospitals, Mumbai, India.
Gayatri Mule
Department of General Surgery, Grant Government Medical College and Sir J.J. Group of Hospitals, Mumbai, India.
Soumi Das
Department of General Surgery, Grant Government Medical College and Sir J.J. Group of Hospitals, Mumbai, India.
Rupali Prakash Choradia
Department of General Surgery, Grant Government Medical College and Sir J.J. Group of Hospitals, Mumbai, India.
Niyati Singh
Department of General Surgery, Grant Government Medical College and Sir J.J. Group of Hospitals, Mumbai, India.
*Author to whom correspondence should be addressed.
Abstract
Primary hyperparathyroidism (PHPT)1 is an endocrine disease that affects 0.1–0.7% of the general population. Surgery to completely remove the pathologic tissue is the only curative and is the gold standard treatment of the disease. Ectopic and supernumerary parathyroid glands are uncommon but present, inferior ectopic are more common compared to superior glands. Their preoperative localization is of utmost importance for proper planning of the causative tissue,thereby avoiding persistent and recurrent symptoms. This is a case presentation of middle aged female who presented with features of osteitis fibrosa cystica involving left femur which was diagnosed on MRI showed raised Calcium and Parathyroid hormone level in serum.Her radiological investigations including specific parathyroid localization studies showed lesion in right lobe of thyroid with normal parathyroid glands with respect to their position and size. The patient underwent right hemithyroidectomy for the lesion. Post operative decrease in parathyroid hormone level and histopathology specimen of hemithyroidectomy specimen confirmed presence of ectopic parathyroid adenoma inside right lobe of thyroid.
Keywords: Parathyroid adenoma, ectopic parathyroid gland, primary hyperparathyroidism, hypercalcemia parathyroid hormone (PTH), intraoperative PTH monitoring