We aimed to determine the prevalence of parathyroid incidentalomas in patients referred for thyroid ultrasonography (US) and investigate the role of chronic thyroiditis on false positive lesions. Patients suspected to have parathyroid lesions during thyroid US were recorded prospectively between August 2009 and January 2010. Patients referred for parathyroid US and patients with known high serum calcium or parathyroid hormone (PTH) levels were excluded. Suspected parathyroid lesions were defined as hypoechoic, homogeneous, solid lesions with regular margins located outside the thyroid lobe, most commonly inferior to the thyroid gland. Thyroid US was performed in 6,528 patients. There were 78 patients (1.19 %) (73 female and 5 male) with suspected parathyroid lesion. The diagnosis of a true parathyroid adenoma was confirmed in 6 (7.69 %) patients. In patients with true adenoma, mean serum calcium, phosphorus, and PTH levels were 10.57 ± 0.48 mg/dl, 3.03 ± 0.52 mg/dl, and 182.91 ± 46.62 pg/ml, respectively. Among 72 patients with false positive parathyroid lesion, antithyroid peroxidase antibody was positive in 50 (69.4 %), antithyroglobulin antibody was positive in 46 (63.9 %), and one of these antibodies were positive in 59 (81.9 %) patients. Also, 46 (63.9 %) of these patients had thyroid dysfunctions (43 hypothyroidism and 3 hyperthyroidism) and 59 (81.9 %) had chronic thyroiditis ultrasonographically. Parathyroid incidentaloma was detected in 0.09 % of patients referred for thyroid US. The presence of clinically or ultrasonographically chronic thyroiditis might cause inadvertent interpretation of a hypoechoic lesion as a parathyroid pathology during thyroid US.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
B.M. Carnaille, F.N. Pattou, C. Oudar, M.C. Lecomte-Houcke, J.E. Rocha, C.A. Proye, Parathyroid incidentalomas in normocalcemic patients during thyroid surgery. World J. Surg. 20(7), 830–834 (1996)
B. Abboud, G. Sleilaty, C. Braidy, C. Ghorra, G. Abadjian, C. Tohme, R. Noun, R. Sarkis, Enlarged parathyroid glands discovered in normocalcemic patients during thyroid surgery. Am. J. Surg. 195(1), 30–33 (2008)
P. Shroff, G.A. McGrath, C.M. Pezzi, Incidentalomas of the parathyroid gland: multiple presentations, variable function, and review of the literature. Endocr. Pract. 11(6), 363–369 (2005)
J.Y. Kwak, E.K. Kim, H.J. Moon, M.J. Kim, S.S. Ahn, E.J. Son, Y.M. Sohn, Parathyroid incidentalomas detected on routine ultrasound-directed fine-needle aspiration biopsy in patients referred for thyroid nodules and the role of parathyroid hormone analysis in the samples. Thyroid 19(7), 743–748 (2009)
A. Frasoldati, M. Pesenti, E. Toschi, C. Azzarito, M. Zini, R. Valcavi, Detection and diagnosis of parathyroid incidentalomas during thyroid sonography. J. Clin. Ultrasound 27(9), 492–498 (1999)
J.P. Bilezikian, J.T. Potts, Gel.-H. Fuleihan, M. Kleerekoper, R. Neer, M. Peacock, J. Rastad, S.J. Silverberg, R. Udelsman, S.A. Wells Jr, Summary statement from a workshop on asymptomatic primary hyperparathyroidism: a perspective for the 21st century. J. Bone Miner. Res. 17(Suppl 2), N2–11 (2002)
A.D. Katz, L.B. Kong, Incidental preclinical hyperparathyroidism identified during thyroid operations. Am. Surg. 58(12), 747–749 (1992)
M. Marchesi, M. Biffoni, R.N. Benedetti, F.P. Campana, Incidental parathyroid adenomas with normocalcemia discovered during thyroid operations: report of three cases. Surg. Today 31(11), 996–998 (2001)
M. Pesenti, A. Frasoldati, C. Azzarito, R. Valcavi, Parathyroid incidentaloma discovered during thyroid ultrasound imaging. J. Endocrinol. Invest. 22(10), 796–799 (1999)
E.L. Whineray Kelly, G. Braatvedt, R. Harman, A parathyroid incidentaloma. Austral. N. Z. J. Surg. 75(5), 367 (2005)
T. Ogawa, M. Kammori, E. Tsuji, H. Kanauchi, R. Kurabayashi, K. Terada, Y. Mimura, M. Kaminishi, Preoperative evaluation of thyroid pathology in patients with primary hyperparathyroidism. Thyroid 17(1), 59–62 (2007)
T. Masatsugu, H. Yamashita, S. Noguchi, R. Nishii, Y. Koga, S. Watanabe, S. Uchino, H. Yamashita, A. Ohshima, S. Kuroki, M. Tanaka, Thyroid evaluation in patients with primary hyperparathyroidism. Endocr. J. 52(2), 177–182 (2005)
S.Y. Morita, H. Somervell, C.B. Umbricht, A.P. Dackiw, M.A. Zeiger, Evaluation for concomitant thyroid nodules and primary hyperparathyroidism in patients undergoing parathyroidectomy or thyroidectomy. Surgery 144(6), 862–866 (2008)
H.H. Chen, Y.W. Chen, C.J. Wu, Primary hyperparathyroidism in Taiwan: clinical features and prevalence in a single-center experience. Endocrine 37(2), 373–378 (2010)
Y.X. Zheng, S.M. Xu, P. Wang, L. Chen, Preoperative localization and minimally invasive management of primary hyperparathyroidism concomitant with thyroid disease. J. Zhejiang Univ. Sci. B 8, 626–631 (2007)
S. Sidhu, P. Campbell, Thyroid pathology associated with primary hyperparathyroidism. Austral. N. Z. J. Surg. 70, 285–287 (2000)
D.J. Bentrem, P. Angelos, M.S. Talamonti, R. Nayar, Is preoperative investigation of the thyroid justified in patients undergoing parathyroidectomy for hyperparathyroidism? Thyroid 12, 1109–1112 (2002)
M. Kösem, E. Algün, C. Kotan, M. Harman, M. Oztürk, Coexistent thyroid pathologies and high rate of papillary cancer in patients with primary hyperparathyroidism: controversies about minimal invasive parathyroid surgery. Acta Chir. Belg. 104, 568–571 (2004)
K. Gul, D. Ozdemir, B. Korukluoglu, P.E. Ersoy, R. Aydin, S.N. Ugras, R. Ersoy, B. Cakir, Preoperative and postoperative evaluation of thyroid disease in patients undergoing surgical treatment of primary hyperparathyroidism. Endocr. Pract. 16(1), 7–13 (2010)
T. Masatsugu, H. Yamashita, S. Noguchi, R. Nishii, Y. Koga, S. Watanabe, S. Uchino, H. Yamashita, A. Ohshima, S. Kuroki, M. Tanaka, Thyroid evaluation in patients with primary hyperparathyroidism. Endoc. J. 52, 177–182 (2005)
X. Serres-Créixams, I. Castells-Fusté, X. Pruna-Comella, V. Yetano-Laguna, V. Garriga-Farriol, E. Gallardo-Agromayor, Paratracheal lymph nodes: a new sonographic finding in autoimmune thyroiditis. J. Clin. Ultrasound 36(7), 418–421 (2008)
Conflict of interest
The authors declare that they have no conflict of interest.
About this article
Cite this article
Ozdemir, D., Arpaci, D., Ucler, R. et al. Parathyroid incidentalomas detected during thyroid ultrasonography and effect of chronic thyroiditis on false positive parathyroid lesions. Endocrine 42, 616–621 (2012). https://doi.org/10.1007/s12020-012-9700-5
- Parathyroid incidentaloma
- Chronic thyroiditis
- Thyroid autoantibodies