Abstract
The details of 7 patients with hyperparathyroidism in whom 8 intrathyroid hyperfunctioning parathyroid glands were located are presented. Seven of the 8 glands were inferior parathyroids and this observation is discussed in the light of current embryological teaching. The intrathyroidal hyperfunctioning parathyroid is considered to be a potential cause of failed parathyroid surgery and, therefore, when an inferior parathyroid gland is missing, it is recommended that the lower pole of the thyroid be incised and, if necessary, a thyroid lobectomy performed.
Résumé
Une série de 7 malades hyperparathyroïdiens qui présentaient des glandes parathyroïdiennes hyperfonctionnelles situées au sein de la thyroïde est présentée par les auteurs. Dans 7 cas sur 8, elles répondaient aux glandes parathyroïdiennes inférieures et ce fait est discuté en fonction de nos connaissances actuelles de l'embryologie. La présence d'une glande parathyroïdienne hyperfonctionnelle au sein de la thyroïde doit être envisagée en cas d'échec de la chirurgie parathyroïdienne. En fait quand une glande parathyroïde inférieure n'est pas retrouvée en cours d'intervention les auteurs recommandent d'inciser le pôle inférieur de la thyroïde et de pratiquer, si nécessaire, une lobectomie thyroïdienne.
Resumen
La glándula paratiroides de ubicación anormal es una bien reconocida causa de fracaso en cirugía paratiroidea. Una de las anomalías más interesantes y provocadoras es la paratiroides hiperfuncionante intratiroidea. Se define la paratiroides intratiroidea como la glándula paratiroides, normal o anormal, que se encuentra totalmente ubicada en el interior de la tiroides y rodeada por parenquima tiroideo. Se presentan las características clínicas, quirúrgicas, y patológicas de 7 pacientes con hiperparatiroidismo, en quienes 8 glándulas paratiroides intratiroideas fueron halladas. Estos 7 casos representan 3.5% de 200 pacientes sometidos a exploración cervical por hiperparatiroidismo entre 1978 y 1984. Siete de las 8 glándulas fueron paratiroides inferiores, hallazgo que es discutido a la luz de conocimientos embriológicos actuales. La paratiroides hiperfuncionante intratiroidea no es una anomalía rara y es considerada como una potencial causa de fracaso en cirugía de paratiroides; por consiguiente, cuando en el curso de la exploración no se encuentre una de las paratiroides inferiores se debe incidir el polo inferior de la tiroides y, si necesario, realizar lobectomía.
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Based on a communication to the British Association of Endocrine Surgeons, Newcastle, May, 1985.
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Wheeler, M.H., Williams, E.D. & Wade, J.S.H. The hyperfunctioning intrathyroidal parathyroid gland: A potential pitfall in parathyroid surgery. World J. Surg. 11, 110–113 (1987). https://doi.org/10.1007/BF01658473
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DOI: https://doi.org/10.1007/BF01658473