Bilateral intrathyroidal hyperplastic parathyroid glands

Davis, Orrin; Scanlon, Edward F.; Pollak, Elizabeth R.; Casey, Joseph J.; Victor, Thomas A.

doi:10.1002/jso.2930270416

Cited by 5 publications

(10 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Velimezis et al also reported a 26-year-old asymptomatic case which demonstrated the concurrence of ectopic ITP, PTC, and ectopic intrathyroidal thymus with a past medical history of genitourinary system disorders [16] . The only 2 cases of bilateral ITP were of abnormal hyper parathyroids; hence, symptoms of hyperparathyroidism were associated with these cases [4] , [12] . The patient in the current study was an asymptomatic 35-year-old female presented with neck swelling with no significant medical or family history.…”

Section: Discussionmentioning

confidence: 97%

“…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] . The current patient showed co-occurrence of bilateral ITP gland with PTC.…”

Section: Discussionmentioning

confidence: 99%

“…The presence of ITP when co-occurring with other thyroidal lesions present a challenge to physicians as due to their rarity, insensitivity to imaging techniques, and their invisibility during thyroidectomy as the result of the lack of a distinguishable cleavage plane with the thyroid parenchyma, surgeons are unaware of their presence inside the thyroid, even if they are found, they simply cannot be easily freed from the thyroidal tissue [4] , [15] . Chen and associates in their study suggested that surgeons should carefully examine the thyroidal tissue to discover any possible normal ITP, so that they can later perform auto-transplantation of the ITP in order to prevent hypocalcemia due to postoperative hyperthyroidism [15] .…”

Section: Discussionmentioning

confidence: 99%

“…The ectopic localization of parathyroid inside the thyroid is uncommon, and it is even rarer when synchronous with another thyroidal tumor, especially non-medullary types [3] . The bilateral presence of ITP is a phenomenal finding with only a few reported cases in the literature [4] .…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

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

Abdullah

Baba

Salih

et al. 2021

International Journal of Surgery Case Reports

View full text Add to dashboard Cite

Introduction Intrathyroidal parathyroid is a parathyroid completely embedded within the thyroid parenchyma. The aim of this study is to present a case with co-occurring bilateral normal intrathyroidal parathyroid glands and papillary thyroid carcinoma (PTC). Case presentation A 35-year-old female presented with anterior neck swelling for a duration of a week. The patient was generally asymptomatic. Ultrasound showed mild enlargement of the thyroid gland, and a well-defined solid nodule measuring 9 ∗ 8 ∗ 7 mm in the left lobe with malignant characteristics. Laboratory findings were within normal limits. Fine needle aspiration of the nodule resulted in the diagnosis of PTC. The patient underwent total thyroidectomy. Histological examination confirmed the diagnosis of well differentiated multifocal bilateral PTC alongside two bilaterally located intrathyroidal parathyroid glands. Discussion The occurrence of normal ITP is exceedingly rare, and even rarer when simultaneous with other thyroidal lesions. It is theorized that inferior parathyroid glands arise from the third pharyngeal pouch, and during embryogenesis they might migrate to other anatomic locations. In this case, two bilateral normal ITP were present with PTC. Conclusion Normal ITP presents a diagnostic challenge due to their high insensitivity to current preoperative diagnostic techniques; hence, surgeons are required to carefully examine thyroid tissue during thyroidectomy when missing parathyroid glands are observed.

show abstract

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Abdullah

Baba

Salih

et al. 2021

International Journal of Surgery Case Reports

View full text Add to dashboard Cite

show abstract

“…A parathyroid gland, whether normal or abnormal, surrounded entirely by thyroid parenchyma with no capsule is considered an intrathyroidal parathyroid and occurs due to aberrant migration of the parathyroid glands during embryogenesis (31). Intrathyroidal parathyroid can be confused with intracapsular parathyroid gland, which is a parathyroid gland situated within the crevices of the thyroid (32,33).…”

Section: Intrathyroid Parathyroidmentioning

confidence: 99%

Parathyroid Imaging: Past, Present, and Future

et al. 2022

View full text Add to dashboard Cite

The goal of parathyroid imaging is to identify all sources of excess parathyroid hormone secretion pre-operatively. A variety of imaging approaches have been evaluated and utilized over the years for this purpose. Ultrasound relies solely on structural features and is without radiation, however is limited to superficial evaluation. 4DCT and 4DMRI provide enhancement characteristics in addition to structural features and dynamic enhancement has been investigated as a way to better distinguish parathyroid from adjacent structures. It is important to recognize that 4DCT provides valuable information however results in much higher radiation dose to the thyroid gland than the other available examinations, and therefore the optimal number of phases is an area of controversy. Single-photon scintigraphy with 99mTc-Sestamibi, or dual tracer 99mTc-pertechnetate and 99mTc-sestamibi with or without SPECT or SPECT/CT is part of the standard of care in many centers with availability and expertise in nuclear medicine. This molecular imaging approach detects cellular physiology such as mitochondria content found in parathyroid adenomas. Combining structural imaging such as CT or MRI with molecular imaging in a hybrid approach allows the ability to obtain robust structural and functional information in one examination. Hybrid PET/CT is widely available and provides improved imaging and quantification over SPECT or SPECT/CT. Emerging PET imaging techniques, such as 18F-Fluorocholine, have the exciting potential to reinvent parathyroid imaging. PET/MRI may be particularly well suited to parathyroid imaging, where available, because of the ability to perform dynamic contrast-enhanced imaging and co-registered 18F-Fluorocholine PET imaging simultaneously with low radiation dose to the thyroid. A targeted agent specific for a parathyroid tissue biomarker remains to be identified.

show abstract

Intrathyroid Parathyroid Adenoma in Primary Hyperparathyroidism: Can It Be Predicted Preoperatively?

et al. 2007

View full text Add to dashboard Cite

show abstract

Bilateral intrathyroidal hyperplastic parathyroid glands

Abstract: A patient with secondary hyperparathyroidism was found to have two intrathyroidal parathyroid glands. Parathyroid glands are found completely within the substance of the thyroid in approximately 2 to 8% of all cases. The surgical approach to hyperparathyroidism is discussed.

Cited by 5 publications

References 11 publications

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

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

Parathyroid Imaging: Past, Present, and Future

Intrathyroid Parathyroid Adenoma in Primary Hyperparathyroidism: Can It Be Predicted Preoperatively?

Contact Info

Product

Resources

About