Sonography of a Typical Parathyroid Adenoma: Solitary Parathyroids as Seen on Ultrasound

Abstract

In this chapter, we discuss typical ultrasound appearances in a series of cases of solitary orthotopic parathyroid adenomas as seen in hyperparathyroidism. On ultrasound imaging, typical adenomas appear as well-defined oval to rounded or elongated homogeneously hypoechoic nodules. This chapter focuses on eutopic nodules found in their typical anatomical locations along the posterior surface of the corresponding thyroid. On technetium-99m sestamibi scan, the adenoma site shows asymmetrical increased uptake of the tracer at the site of adenoma on early scan and retention of the radiotracer on the delayed scan. The choice of management is either surgical or medical depending on the clinical symptoms, age, serum calcium, serum parathyroid hormone levels and pre-existing comorbidities or patient preferences. The detailed descriptions of the various cases and ultrasound images and video clips are being compiled and illustrated here.