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[Supernumerary ectopic hyperfunctioning parathyroid gland: a potential pitfall in surgery for sporadic primary

J F Henry1, T Defechereux, M Raffaelli

  • 1Service de chirurgie générale et endocrinienne, CHU La Timone, Marseille, France.

Annales De Chirurgie
|June 1, 2000
PubMed
Summary

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Ectopic supernumerary parathyroid glands are rare in sporadic primary hyperparathyroidism. Careful neck exploration is recommended when four normal glands are found to ensure complete biochemical cure.

Area of Science:

  • Endocrinology
  • Surgical Pathology

Context:

  • Sporadic primary hyperparathyroidism can be caused by ectopic supernumerary parathyroid glands.
  • These glands are often found outside the typical anatomical locations in the neck.

Purpose:

  • To report a series of nine patients with sporadic primary hyperparathyroidism due to an ectopic supernumerary hyperfunctioning parathyroid gland.
  • To evaluate the incidence and management of these rare cases.

Summary:

  • Nine patients (0.69% of 1,307) with sporadic primary hyperparathyroidism had an ectopic supernumerary gland.
  • Glands were located in the mediastinum, carotid sheath, or vagus nerve, found during initial or reoperative surgery.
  • All patients were cured biochemically after a mean follow-up of five years.

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Impact:

  • The low incidence does not support routine preoperative localization or intra-operative parathormone assays.
  • Routine exploration for a fifth gland is advised when four normal glands are identified during initial surgery or in cases of multiglandular disease.