Abstract
A 57-year-old woman with a history of brain infarction was referred to our clinic for evaluation of primary hyperparathyroidism. Cervical ultrasonography failed to localize the pathological parathyroid gland. 99mTc-MIBI scintigraphy showed an abnormal up-take lesion near the right side of the larynx. CT revealed a 1.5-cm enhanced mass posterior to the right hypopharyngeal pyriform sinus. The mass was removed through cervical incision, weighed 512mg and was pathologically diagnosed as a parathyroid adenoma. Her serum calcium level and intact PTH level returned to within the normal range on postoperative day 1, and did not rise six months after operation. We consider that the ectopic parathyroid adenoma arose from the parathyroid tissue which had been left posterior to the pharynx when migrating from the fourth branchial pouch to the dorsal aspect of the thyroid.
