Abstract
A 55-year-old lady presented with symptoms of generalized aches and pains and lethargy. There was no family history of relevant disorders. Biochemical investigations showed elevated serum calcium (2.84 mmol/L) and elevated PTH at 16.4 pmol/L. Urine investigations in the form of calcium:creatinine clearance ratio ruled out familial hypocalciuric hypercalcemia (FHH). DEXA scan of her skeletal system showed moderate osteoporosis with T-score of −2.5 at hip and spine. Imaging to localize her parathyroid glands was discordant with Technetium 99m Sestamibi (MIBI) scan showing a MIBI-avid lesion to suggest a parathyroid adenoma or hyperplasia at the left superior pole. However, the US scan did not reveal any obvious lesion.
Rajeev Parameswaran is the lead author of this chapter.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Professor Owen FRS, F, c. III. On the anatomy of the Indian rhinoceros (Rh. Unicornis, L.). Trans Zool Soc London. 1852;4(2):31–58.
Seipel C. On a new gland in man and several mammals (glandulae parathyroideae) by Ivar Sandström (English translation). Baltimore: Johns Hopkins Press; 1938.
Bliss RD, Gauger PG, Delbridge LW. Surgeon's approach to the thyroid gland: surgical anatomy and the importance of technique. World J Surg. 2000;24(8):891–7.
Roy M, Mazeh H, Chen H, Sippel RS. Incidence and localization of ectopic parathyroid adenomas in previously unexplored patients. World J Surg. 2013;37(1):102–6.
Noussios G, Anagnostis P, Natsis K. Ectopic parathyroid glands and their anatomical, clinical and surgical implications. Exp Clin Endocrinol Diabetes. 2012;120(10):604–10.
Mariani G, Gulec SA, Rubello D, Boni G, Puccini M, Pelizzo MR, et al. Preoperative localization and radioguided parathyroid surgery. J Nucl Med. 2003;44(9):1443–58.
Eslamy HK, Ziessman HA. Parathyroid scintigraphy in patients with primary hyperparathyroidism: 99mTc sestamibi SPECT and SPECT/CT. Radiographics. 2008;28(5):1461–76.
Chopra A, Bansal R, Sharma N, Kulshreshtha B. Parathyroid adenoma within the carotid sheath. Acta Endocrinol (Buchar). 2020;16(4):497–500.
Mahajan S, Schoder H. Ectopic undescended parathyroid adenoma-SPECT/CT avoids false-negative interpretation on 99mTc-MIBI dual-phase scintigraphy. Clin Nucl Med. 2018;43(3):199–200.
Ezzine A, Ben FM, Azzabi A, Talmoudi A, Sahtout W, Boukadida R, et al. Undescended parathyroid gland mimicking salivary gland uptake. J Nephrol Ther. 2016;6(268):2161.
Boccalatte LA, Higuera F, Gómez NL, de la Torre AY, Mazzaro EL, Galich AM, et al. Usefulness of 18F-fluorocholine positron emission tomography–computed tomography in locating lesions in hyperparathyroidism: a systematic review. JAMA Otolaryngol Head Neck Surg. 2019;145(8):743–50.
Ansquer C, Mirallié E, Carlier T, Abbey-Huguenin H, Aubron F, Kraeber-Bodéré F. Preoperative localization of parathyroid lesions. Value of 99mTc-MIBI tomography and factors influencing detection. Nuklearmedizin. 2008;47(4):158–62.
Libé R, Calvani J, Cottereau AS, Connan TL, Gaujoux S, Groussin L, et al. An ectopic parathyroid adenoma mimicking a carotid body paraganglioma. J Endocr Soc. 2020;4(12):bvaa143.
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2023 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
About this chapter
Cite this chapter
Agarwal, A., Fernando, R., Parameswaran, R., Mishra, A., Pradhan, R. (2023). Ectopic Locations. In: Case Studies in Thyroid and Parathyroid Tumors. Springer, Singapore. https://doi.org/10.1007/978-981-99-0938-4_25
Download citation
DOI: https://doi.org/10.1007/978-981-99-0938-4_25
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-99-0937-7
Online ISBN: 978-981-99-0938-4
eBook Packages: MedicineMedicine (R0)