Abstract
We herein report a case of ectopic parathyroid adenoma in the thyroid gland. Double parathy roid adenomas are a rare cause of primary hyperparathyroidism. A 66-year-old man presented with hypercalcemia and an elevated intact parathyroid hormone level. Ultrasonography and CT scan ex aminations showed an enlarged superior right side of the parathyroid gland. 99mTc methoxyibutyli sonitrile scintigraphy showed a hot-spot in the superior right side of parathyroid gland. From these data, he was diagnosed to have primary hyperparathyroidism. As a result, he underwent his first op eration in December 2003. However, he had persistent hypercalcemia for five months. 99mTc methoxyibutylisonitrile scintigraphy was performed and the findings showed a hot-spot on the right side of the thyroid gland in April 2004. He therefore underwent a second operation consisting of a hemithyroidectomy and a total parathyroidectomy, which thus resulted in normocalcemia. Histo logical examinations of both operations revealed parathyroid adenomas. We also reviewed 50 pa tients with hyperparathyroidism treated at the Department of Otolaryngology, Head and Neck Surgery, Kurume University Hospital between 1996 and 2004, consisting of 24 primary and 26 secon dry hyperparathyroidisms. Among the primary cases, 2 cases were ectopic (8.3%). Histopathogi cal examinations revealed 18 parathyroid adenomas and 6 hyperplasia. Ultrasonography was thus found to be the most effective tool for accurately diagnosing of hyperparathyroid gland tumors.
