A novel nomenclature to classify parathyroid adenomas

Area of Science:

• Anatomy
• Endocrinology
• Surgical Oncology

Background:

• Accurate communication of parathyroid adenoma locations is crucial for surgical and specialist collaboration.
• Existing descriptions lack uniformity and precision, hindering effective information exchange.
• A standardized nomenclature is needed to precisely describe common parathyroid adenoma locations.

Purpose of the Study:

• To develop and present a novel nomenclature for describing parathyroid adenoma locations.
• To provide a precise method for communicating the most frequent locations of parathyroid adenomas.
• To establish a system applicable across radiology, operative, and pathology reports.

Main Methods:

• A classification scheme based on anatomical detail from imaging was developed.
• The system utilizes quadrants and anterior-posterior depth relative to the recurrent laryngeal nerve and thyroid parenchyma.
• The nomenclature assigns letters A-G to specific gland locations.

Main Results:

• Type A: Superior pedicle, lateral to recurrent laryngeal nerve within thyroid capsule.
• Type B: Posterior superior gland in tracheoesophageal groove, same thyroid plane.
• Type C: Posterior superior gland in tracheoesophageal groove, below thyroid inferior pole.
• Type D: Mid-posterior thyroid, near recurrent laryngeal nerve/thyroid vessels; difficult dissection.
• Type E: Inferior gland near thyroid pole, lateral to thyroid and anterior trachea.
• Type F: Inferior gland descended into thyrothymic ligament/thymus; anterior to trachea.
• Type G: Rare, truly intrathyroidal parathyroid gland.

Conclusions:

• A reproducible nomenclature offers consistent communication for parathyroid adenoma location.
• Uniform adoption can reliably convey exact gland location, reducing lengthy descriptions.
• This system can benefit surgical planning, operative, and pathology reporting.