Multiple ectopic parathyroid adenomas

Dedivitis, Rogério Aparecido; Guimarães, André Vicente; Pontes, Gustavo Bastos de Goes

doi:10.1590/s1516-31802004000100008

Cited by 7 publications

(5 citation statements)

References 3 publications

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“…Assim, os dois métodos em conjunto identificaram 16 glândulas aumentadas. A cintilografia identificou ainda, em um dos pacientes, uma segunda imagem sugestiva de paratireóide localizada caudalmente ao recesso piriforme esquerdo, caracterizando-se, ao histopatológico, adenoma duplo 7 . O exame histopatológico de todas as glândulas evidenciou adenoma de paratireóide, sendo que em dois exames caracterizou-se o adenoma duplo.…”

Section: Resultsunclassified

Associação de doença tireoideana ao adenoma de paratireóide

Dedivitis

Sauma

et al. 2007

Rev. Col. Bras. Cir.

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OBJETIVO: avaliar a prevalência de doença incidental de tireóide em tratamento cirúrgico por HPP. MÉTODO: De janeiro de 1998 a dezembro de 2004, 20 pacientes com evidência clínica e laboratorial de HPP foram submetidos à paratiroidectomia. A população de pacientes incluía 15 mulheres e cinco homens, com idade variando de 44 a 83 anos. Os dados utilizados para o diagnóstico de doença tireoidiana: clínico, laboratorial, ultra-sonografia com Doppler, exame citopatológico da punção aspirativa por agulha fina (PAAF) e exame durante a exploração intra-operatória. Todos os pacientes eram portadores de adenoma de paratireóide, sendo dois duplos. RESULTADOS: Ao exame clínico foi detectado alteração à palpação da tireóide em sete pacientes, com cinco indicações cirúrgicas; a avaliação laboratorial mostrou alteração da função tireoidiana em três pacientes; a ultra-sonografia mostrou doença nodular em 15 pacientes, mas não determinou indicação cirúrgica; a PAAF de nódulo tireoidiano foi indicada em nove pacientes, com três pacientes de carcinoma papilífero; a exploração intra-operatória não adicionou achado ao exame ultra-sonográfico. CONCLUSÃO: A associação patológica entre doenças da tireóide e da paratireóide é freqüente. A ultra-sonografia é o método mais sensível de detecção, porém, o exame clínico e a PAAF são os que revelaram impacto na indicação cirúrgica sobre a glândula tireóide no momento da paratireoidectomia.

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Section: Resultsunclassified

Associação de doença tireoideana ao adenoma de paratireóide

Dedivitis

Sauma

et al. 2007

Rev. Col. Bras. Cir.

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“…Supernumerary parathyroid glands are seen in 2.5%–15% of patients while <3% of patients may have only three glands ( 10 , 11 ). Fourteen percent of all parathyroid adenomas are found at ectopic locations ( 12 ). While the thymus is the most frequent ectopic location of parathyroid adenomas, additional reported locations include the posterior mediastinum, thyrothymic ligament, retropharyngeal space, intra-thyroidal, retroesophageal region, or within the carotid sheath ( Figure 3 ).…”

Section: Discussionmentioning

confidence: 99%

Case Report: Nine-year-old with parathyroid adenoma within the piriform sinus

et al. 2023

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We present the case of a 9-year-old girl who presented with symptomatic hypercalcemia from primary hyperparathyroidism (PHPT). Laboratory results revealed elevated serum calcium 12.1 mg/dl (ref: 9.1–10.4), elevated ionized calcium 6.8 (ref: 4.5–5.6) mg/dl, phosphorus 3.8 (ref: 3.3–5.1) mg/dl, 25-OH vitamin D 20.1 (30–100) ng/ml, and elevated intact PTH 70 (15-65) pg/ml, consistent with the diagnosis of PHPT. She had persistent hyperparathyroidism after bilateral neck exploration, left thyroid lobectomy, and transcervical thymectomy. Neither inferior gland was identified. No parathyroid tissue was seen on histology. Repeat preoperative imaging identified a 7-mm × 5-mm adenoma on 4DCT not seen on 99Tc-sestamibi parathyroid scan. The patient then underwent a successful redo parathyroidectomy with removal of a submucosal left parathyroid adenoma at the superior aspect of the thyroid cartilage in the piriform sinus. Her biochemical work-up remains consistent with surgical cure 6 months after surgery. Herein, we also review common locations for ectopic parathyroid adenomas.Clinical Trial RegistrationNCT04969926.

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“…4,5 Ectopic parathyroid adenoma in the piriform sinus is rare, with only a few, previously documented cases found on in the medical literature. [6][7][8] Preoperative imaging for PH relies primarily on ultrasound and 99m Tc Sestamibi scintigraphy. The typical sonographic appearance of a parathyroid adenoma is that of an ovalshaped hypoechoic lesion found in close relation to the thyroid gland.…”

Section: Discussionmentioning

confidence: 99%

Ectopic Parathyroid Adenoma in Piriform Sinus: Case Report and Review of the Literature

et al. 2019

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During routine blood work, a 53-year-old female patient was noted to have asymptomatic hypercalcemia and subsequently found to have hyperparathyroidism. Localization studies for a suspected parathyroid adenoma included 99m Tc Sestamibi scintigraphy, Single Photon Emission Computed Tomography (SPECT)/computed tomography (CT) study, and ultrasound of the neck, which were initially read as negative for parathyroid adenoma. A contrast-enhanced CT scan of the neck was performed to locate the suspected parathyroid adenoma and demonstrated a soft tissue lesion within the right piriform sinus. Flexible fiber optic nasolaryngoscopy revealed a submucosal lesion in the right piriform sinus. Following these findings, the initial 99m Tc Sestamibi scintigraphy and SPECT/ CT were reviewed with confirmation of a focal area of increased activity superior to the right thyroid lobe, corresponding to a nodule in the right piriform sinus that demonstrated increased activity on SPECT/CT. The patient was brought to the operating room for surgical management where a laryngoscope and operating microscope were utilized. The encapsulated lesion was dissected and excised in total. The parathyroid hormone and ionized calcium levels normalized postoperatively. Pathology confirmed a parathyroid adenoma. Parathyroid adenomas are the most common cause of primary hyperparathyroidism. Sixteen percent of parathyroid adenomas can be situated in an ectopic location. Ectopic parathyroid adenomas in the piriform sinus are rare with only a few previously documented cases. We document a rare case of ectopic parathyroid adenoma in the piriform sinus overlooked on initial imaging studies. These lesions can be challenging to localize, however, an understanding of embryology, close scrutiny of possible ectopic locations, and the application of complementary imaging techniques may prove useful for surgeons and clinicians.

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Multiple ectopic parathyroid adenomas

Abstract: Routine bilateral neck surgery should be performed as a rule. We use ultrasound and technetium sestamibi scanning as a routine for preoperative localization studies. It is helpful to have an experienced surgeon for the localization.

Cited by 7 publications

References 3 publications

Associação de doença tireoideana ao adenoma de paratireóide

Associação de doença tireoideana ao adenoma de paratireóide

Case Report: Nine-year-old with parathyroid adenoma within the piriform sinus

Ectopic Parathyroid Adenoma in Piriform Sinus: Case Report and Review of the Literature

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