Ipsilateral double parathyroid adenoma and thyroid hemiagenesis

Area of Science:

• Endocrinology
• Surgical Pathology
• Developmental Biology

Background:

• Thyroid dysgenesis is a rare congenital anomaly.
• Primary hyperparathyroidism can be associated with parathyroid and thyroid gland abnormalities.
• Accurate diagnosis of these rare conditions is challenging.

Observation:

• A patient presented with symptoms of primary hyperparathyroidism.
• Preoperative imaging (sestamibi, ultrasound) suggested thyroid nodules.
• Fine-needle aspiration biopsies were inconclusive.
• Intraoperative findings revealed left thyroid lobe dysgenesis and double intrathyroidal parathyroid adenomas.

Findings:

• Surgical removal of the double parathyroid adenomas led to normalization of intact parathyroid hormone levels.
• The patient achieved a long-term cure for primary hyperparathyroidism.
• The case highlights the association between thyroid dysgenesis and parathyroid disease.

Implications:

• Clinicians must maintain a high index of suspicion for rare developmental anomalies in thyroid and parathyroid disorders.
• Thorough physical examination and careful review of imaging are essential for diagnosis.
• Early and accurate diagnosis can lead to successful management and cure.