Citation Information :
Roy A, Khan MH, Frazzetta J, Kabaker AS, De Jong S. Undescended Parathyroid Adenomas: A Leading Cause of Persistent Primary Hyperparathyroidism. World J Endoc Surg 2020; 12 (3):132-135.
Aim: We present the case of a 64-year-old man with symptomatic primary hyperparathyroidism (PHPT) who was found to have a rare undescended parathyroid adenoma (UPA). While UPAs have a low prevalence, they are challenging cases for endocrine surgeons. We include background information and a summary of the literature of UPAs and presentation, workup, management, and outcomes of this patient.
Introduction: Undescended parathyroid adenomas are rare ectopic glands that are found above the upper pole of the thyroid gland.1 They are difficult to localize on routine imaging and require strategic preoperative planning to determine the surgical approach.
Case description: A 64-year-old man presented to our tertiary care center with symptomatic PHPT. Sestamibi with SPECT/CT showed a 1.4 cm focus of uptake in the left upper neck that was suspicious for an ectopic UPA.
Conclusion: With appropriate preoperative imaging and planning, the patient was able to undergo curative minimally invasive parathyroidectomy. The patient had an uncomplicated postoperative recovery with resolution of symptoms and normalization of calcium and parathyroid hormone (PTH) levels.
Clinical significance: Undescended parathyroid adenomas are difficult to locate and are a leading cause of persistent PHPT, failed cervical explorations, and patient morbidity.2 Preoperative imaging is key to localizing these adenomas for successful first-time explorations and minimally invasive parathyroidectomies.
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