Skip to main content


Log in

A Novel Nomenclature to Classify Parathyroid Adenomas

  • Published:
World Journal of Surgery Aims and scope Submit manuscript



A uniform and reliable description of the exact locations of adenomatous parathyroid glands is necessary for accurate communications between surgeons and other specialists. We developed a nomenclature that provides a precise means of communicating the most frequently encountered parathyroid adenoma locations.


This classification scheme is based on the anatomic detail provided by imaging and can be used in radiology reports, operative records, and pathology reports. It is based on quadrants and anterior-posterior depth relative to the course of the recurrent laryngeal nerve and the thyroid parenchyma. The system uses the letters A-G to describe exact gland locations.


A type A parathyroid gland is a gland that originates from a superior pedicle, lateral to the recurrent laryngeal nerve compressed within the capsule of the thyroid parenchyma. A type B gland is a superior gland that has fallen posteriorly into the tracheoesophageal groove and is in the same cross-sectional plane as the superior portion of the thyroid parenchyma. A type C gland is a gland that has fallen posteriorly into the tracheoesophageal groove and on a cross-sectional view lies at the level of or below the inferior pole of the thyroid gland. A type D gland lies in the midregion of the posterior surface of the thyroid parenchyma, near the junction of the recurrent laryngeal nerve and the inferior thyroid artery or middle thyroidal vein; because of this location, dissection is difficult. A type E gland is an inferior gland close to the inferior pole of the thyroid parenchyma, lying in the lateral plane with the thyroid parenchyma and anterior half of the trachea. A type F gland is an inferior gland that has descended (fallen) into the thyrothymic ligament or superior thymus; it may appear to be “ectopic” or within the superior mediastinum. An anterior-posterior view shows the type F gland to be anterior to the trachea. A type G gland is a rare, truly intrathyroidal parathyroid gland.


A reproducible nomenclature can provide a means of consistent communication about parathyroid adenoma location. If uniformly adopted, it has the potential to reliably communicate exact gland location without lengthy descriptions. This system may be beneficial for surgical planning as well as operative and pathology reporting.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others


  1. Hamidi S, Hedayat A, Esfahanian F et al (2007) Distribution of solitary parathyroid adenoma over the parathyroid glands and its surgical management. J Coll Physicians Surg Pak 17:619–621

    PubMed  Google Scholar 

  2. Debruyne F, Ostyn F, Delaere P (1997) Distribution of the solitary adenoma over the parathyroid glands. J Laryngol Otol 111:459–460

    PubMed  CAS  Google Scholar 

  3. Thompson GB, Grant CS, Perrier ND et al (1999) Reoperative parathyroid surgery in the era of sestamibi scanning and intraoperative parathyroid hormone monitoring. Arch Surg 134:699–704 discussion 704-695

    Article  PubMed  CAS  Google Scholar 

  4. Harris GJ (1999) Orbital vascular malformations: a consensus statement on terminology and its clinical implications. Orbital Society. Am J Ophthalmol 127:453–455

    Article  PubMed  CAS  Google Scholar 

  5. Spetzler RF, Detwiler PW, Riina HA et al (2002) Modified classification of spinal cord vascular lesions. J Neurosurg 96:145–156

    PubMed  Google Scholar 

  6. Erbil Y, Barbaros U, Tukenmez M et al (2008) Impact of adenoma weight and ectopic location of parathyroid adenoma on localization study results. World J Surg 32:566–571

    Article  PubMed  Google Scholar 

  7. Akerstrom G, Malmaeus J, Bergstrom R (1984) Surgical anatomy of human parathyroid glands. Surgery 95:14–21

    PubMed  CAS  Google Scholar 

  8. Wang C (1976) The anatomic basis of parathyroid surgery. Ann Surg 183:271–275

    Article  PubMed  CAS  Google Scholar 

Download references


We acknowledge the support of our generous donors, including grateful patients and the Faith Foundation.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Nancy D. Perrier.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Perrier, N.D., Edeiken, B., Nunez, R. et al. A Novel Nomenclature to Classify Parathyroid Adenomas. World J Surg 33, 412–416 (2009).

Download citation

  • Published:

  • Issue Date:

  • DOI: