Abstract
This paper describes a case of parathyroid adenoma which was difficult to differentiate from hyperplasia preand intraoperatively due the coexistence of a cyst in another parathyroid gland.
A 21-year-old female was admitted to the hospital because of close examination for hypertension. High levels in serum calcium and parathormone and low level in serum phosphate were revealed, and the patient was diagnosed as primary hyperparathyroidism. Before surgery two enlarged parathyroid glands (right upper and left lower) were delineated by ultrasonography and parathyroid scintigraphy. It was not known whether hyperparathyroidism was caused by double adenomas or hyperplasia, but surgery was performed. During surgery enlarged right upper and left lower glands and a normal left upper gland were observed. The right lower gland was not found in the corresponding area. Without confirming adenoma or hyperplasia, surgery was completed after removing the two enlarged glands. Postoperative histological examination revealed parathyroid adenoma in the right upper gland and a cyst in the left lower gland.
