Recurrent Primary Hyperparathyroidism: A Diagnostic Challenge in a Supernumerary Intrathyroidal Dormant Adenoma
Frédéric Sebag, Aoife Lowery, Charles Vanbrugghe, Claudio Golffier, Jean Francois Henry
Citation Information :
Sebag F, Lowery A, Vanbrugghe C, Golffier C, Henry JF. Recurrent Primary Hyperparathyroidism: A Diagnostic Challenge in a Supernumerary Intrathyroidal Dormant Adenoma. World J Endoc Surg 2015; 7 (2):39-43.
Recurrent primary hyperparathyroidism is a rare entity and presents a significant surgical challenge.
Presentation of case
We present the case of a 53-year-old female with recurrent primary hyperparathyroidism, which was caused by the very rare occurrence of a metachronous parathyroid adenoma in a supernumerary intrathyroidal parathyroid.
Discussion
This unique case highlights the challenges that arise in the evaluation of recurrent hyperparathyroidism in which even a thorough preoperative evaluation including radiographic, nuclear medicine studies and fine needle aspiration cytology did not facilitate a definitive preoperative diagnosis.
Conclusion
The management approach for these patients requires meticulous planning, experience and appropriate use of intraoperative adjuncts to guide surgical strategy.
How to cite this article
Lowery A, Vanbrugghe C, Golffier C, Sebag F, Henry JF. Recurrent Primary Hyperparathyroidism: A Diagnostic Challenge in a Supernumerary Intrathyroidal Dormant Adenoma. World J Endoc Surg 2015;7(2):39-43.
Is minimally invasive parathyroidectomy associated with greater recurrence compared to bilateral exploration? Analysis of more than 1,000 cases. Surgery 2012;152(6):1008-1015.
Abandoning unilateral parathyroidectomy: why we reversed our position after 15,000 parathyroid operations. J Am Coll Surg 2012;214(3):260-269.
Surgical anatomy of human parathyroid glands. Surgery 1984 Jan;95(1):14-21.
Parathyroid pathology in an intrathyroidal position. Am J Surg 1992 Nov;164(5):496-500.
Hyperparathyroidism and intrathyroid parathyroid gland. 43 cases. Ann Chir 1994;48(6):501-506.
Intrathyroid parathyroid adenoma: incidence and location—the case against thyroid lobectomy. Otolaryngol Head Neck Surg 2011;144(6):867-871.
Reoperative parathyroid surgery: the importance of ectopic location and multigland disease. ANZ J Surg 2006 Dec;76(12):1048-1050.
Reoperation for persistent or recurrent primary hyperparathyroidism. Langenbecks Arch Surg 1998;383(2):174-179.
Reoperation for persistent or recurrent primary hyperparathyroidism. Arch Surg 1996;131(8):861-867.
Reoperation for primary hyperparathyroidism: Tips and tricks. Langenbecks Arch Surg 2010 Feb;395(2):103-109.
Intrathyroid parathyroid adenoma in primary hyperparathyroidism: can it be predicted preoperatively? World J Surg 2007 Arp;31(4):817-823.
Sonography of intrathyroid parathyroid adenomas: are there distinctive features that allow for preoperative identification? Eur J Radiol 2013;82(1):e22-27.
Intrathyroidal oncocytic parathyroid adenoma: a diagnostic pitfall on fine needle aspiration. Diag Cytopath 38(11): 833-836.
Ultrasound guided fine needle aspiration biopsy of parathyroid gland and lesions. Cyto j 2006;3:6.
Parathyroid cytology: avoiding diagnostic pitfalls. Head Neck 2002;24:157-164.
Intrathyroid parathyroid adenoma: incidence and location—the case against thyroid lobectomy. Otolaryngol Head Neck Surg 2011;144(6):867-871.
Intrathyroid adenomas in primary hyperparathyroidism: are they frequent enough to guide surgical strategy? Surg Innov 2011;18(4):373-378.
Role of parathyroid hormone estimation in needle washing of parathyroid aspiration biopsy in localizing 99m Tc-sestamibi negative primary hyperparathyroidism: a series of seventeen patients. Clin Otolaryngol 2014 Apr 29. doi : 10.1111/coa.12248.
Rapid intraoperative parathyroid hormone assay in fine needle aspiration for differential diagnosis in thyroid and parathyroid surgery. Clin Chem Lab Med 2010 Sep;48(9):1313-1317.
Navigation with use of intraoperative ultrasound in search for neoplastic lesions of endocrine glands. Pol Przegl Chir 2013;1;85(5):262-270.