Parathyromatosis—A rare occurrence along the endoscopic tract detected on fine needle aspiration cytology

Abstract

Parathyromatosis is a rare cause of recurrent or persistent hyperparathyroidism after parathyroidectomy. The knowledge of such an entity is essential for clinical suspicion as well as cytological diagnosis and can be confirmed by ancillary techniques. We report a case, previously operated endoscopically for parathyroid adenoma, who presented with recurrent hyperparathyroidism and was found to have multiple tiny subcutaneous chest wall nodules along the endoscopic tract. Fine needle aspiration cytology coupled with immunocytochemistry confirmed parathyroid tissue. Clinical awareness of this entity can help in early detection of the cause of persistent hyperparathyroidism in these patients. Diagn. Cytopathol. 2016;44:1125-1127. © 2016 Wiley Periodicals, Inc.

Parathyromatosis

“…[ 1 ] I would like to state that such incident had already been reported and diagnosed by fine-needle aspiration cytology coupled with immunohistochemistry. [ 2 ] Another case following endoscopic parathyroidectomy was also reported by Wu et al . [ 3 ] It has also been mentioned that in the minimally invasive technique, dissection must be performed carefully to avoid nerve injury and rupture of the capsule which can cause parathyromatosis.…”

Case report: Microwave ablation is a safe and effective method for primary hyperparathyroidism in pregnancy

“…However, there are certain risks associated with any invasive procedures, such as neck hematoma and damages to the recurrent laryngeal nerve, esophagus and trachea. Besides, parathyromatosis is also a serious complication after needle biopsy of parathyroid lesions ( 33 ). Therefore, we must inform the patients of the risks associated with needle biopsy and take measures to avoid them as much as possible.…”

Intractable Parathyromatosis despite extensive surgical interventions: A case report with literature review

“…Co-administration of paricalcitol and ibandronate showed a good response as reported by Daphnis et al [ 12 ] Our case was started on a trial of medical management after the 4th reoperation, which was not effective and did not control her condition, as she still had persistent hyperparathyroidism and went for four more reoperations. The rate of recurrence is high, parathyroid tissue could not be seen during the operation or resected completely as the locations are not anticipated, Sudha et al surprisingly reported tissue seeding in the endoscopic operation tracts [ 13 ]. Most of the reported cases were reoperated a few times unlike our case which had multiple flares of the disease that required 8 extensive surgical interventions, she showed partial control that required medical management over the years.…”