1. Persistent primary hyperparathyroidism caused by an ectopic adenoma in the piriform sinus: case report and review of the literature
- Author
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Chiara Sardella, Veronica Seccia, Massimo Giambalvo, Laura Pierotti, Elisa Dinoi, Simone Della Valentina, Elena Pardi, Gabriele Materazzi, Iacopo Dallan, Stefano Berrettini, and Filomena Cetani
- Subjects
ectopic parathyroid adenoma ,parathyroid glands ,transoral robotic parathyroidectomy ,pyriform sinus ,persistent primary hyperparathyroidism ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
IntroductionPrimary hyperparathyroidism (PHPT) is a common endocrine disorder in which surgery is the only curative therapy. Ectopic parathyroid adenoma in the pyriform sinus resulting from a pathological migration of parathyroid glands along the embryological development is a rare cause of PHPT. We describe a case of a persistent primary hyperparathyroidism after previous unsuccessful surgery due to an ectopic parathyroid adenoma within the pyriform sinus and we review the previous reports on this issue.Case presentationA 62-year-old woman was referred for persistent hypercalcemia following unsuccessful cervical exploratory surgery. Cervical ultrasound did not detect any parathyroid abnormalities. At variance, 99mTc-sestamibi SPECT/CT and CT scan of the neck identified a parathyroid adenoma in the left pyriform sinus, which was confirmed by endoscopy. The patient was successfully treated by transoral robotic resection and the pathology confirmed a parathyroid adenoma.ConclusionsThe ectopic parathyroid adenoma in the pyriform sinus is so uncommon that only fourteen cases have been reported. However, the pyriform sinus should be considered a possible location of ectopic parathyroid glands, especially in the setting of persistent or recurrent PHPT after parathyroid surgery.
- Published
- 2024
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