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The Parathyroid Glands

The Parathyroid Glands

The two pairs of parathyroid glands embedded within the posterior surface of the thyroid gland are restricted by a dense capsule around them. These glands comprise two distinct cell populations—parathyroid oxyphil and parathyroid principal cells- pivotal in calcium homeostasis.
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by producing...

The Thyroid Gland

The Thyroid Gland

The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...

Hyperthyroidism II: Pathophysiology

Hyperthyroidism II: Pathophysiology

Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH receptors...

Hyperthyroidism I: Introduction

Hyperthyroidism I: Introduction

Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...

Graves Disease II: Pathophysiology

Graves Disease II: Pathophysiology

Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor, and heat...

Goiter

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Goiter refers to an abnormal enlargement of the thyroid gland that may appear as a diffuse goiter (uniform enlargement) or nodular (single or multiple nodules). Functionally, it is classified as nontoxic (normal/low hormone levels) or toxic (excess hormone production).PathophysiologyDiffuse thyroid enlargement typically results from prolonged stimulation by thyroid-stimulating hormone (TSH) or TSH-like agents, commonly seen in hypothyroidism or iodine deficiency. In contrast, in hyperthyroid...

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Related Experiment Video

Updated: May 25, 2026

An Orthotopic Mouse Model of Anaplastic Thyroid Carcinoma

An Orthotopic Mouse Model of Anaplastic Thyroid Carcinoma

Published on: April 17, 2013

A parathyroid carcinoma within a cold thyroid nodule.

Ll Travaini¹, G Trifiro, G Paganelli

¹Nuclear Medicine Division, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy.

Ecancermedicalscience

|January 26, 2012

Summary

A rare case of parathyroid carcinoma presenting as a thyroid nodule with hypercalcemia was diagnosed using advanced imaging. Surgical removal confirmed the diagnosis, highlighting the importance of comprehensive evaluation for thyroid nodules.

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Area of Science:

Endocrinology
Oncology
Nuclear Medicine

Background:

Thyroid nodules are common, but malignancy is rare.
Hypercalcemia can be caused by primary hyperparathyroidism, including parathyroid carcinoma.
Differentiating thyroid and parathyroid pathology can be challenging.

Observation:

A 71-year-old woman presented with a right thyroid nodule and hypercalcemia.
Ultrasound showed a vascular thyroid nodule, cold on (99m)Tc-sodium pertechnetate scan.
Fine-needle aspiration revealed a follicular lesion, with blood tests indicating hypercalcemia and hyperparathyroidism.

Findings:

A (99m)Tc-methoxyisobutylisonitrile ((99m)Tc-Sestamibi) scan identified increased uptake in the thyroid nodule, correlating with the hyperfunctioning parathyroid tissue.
Histopathology confirmed parathyroid carcinoma with follicular hyperplasia, positive for PTH and chromogranin A, with a Ki-67 index of 10%.

Implications:

This case underscores the diagnostic utility of (99m)Tc-Sestamibi scintigraphy in localizing ectopic or intrathyroidal parathyroid lesions.
Early and accurate diagnosis of parathyroid carcinoma is crucial for appropriate surgical management and improved patient outcomes.
Integrated imaging and pathological findings are essential for managing complex endocrine disorders involving the thyroid and parathyroid glands.