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Parathyroid Adenoma within the Carotid Sheath.
A Chopra1, R Bansal1, N Sharma1
1"Dr. Ram Manohar Lohia" Hospital, Department of Endocrinology, New Delhi, India.
Acta Endocrinologica (Bucharest, Romania : 2005)
|June 4, 2021
Summary
Ectopic parathyroid adenomas, rare causes of primary hyperparathyroidism, can be challenging to locate. This case highlights an undescended adenoma in the carotid sheath, emphasizing careful surgical consideration.
Area of Science:
- Endocrinology
- Surgical Oncology
- Radiology
Background:
- Ectopic parathyroid adenomas are uncommon causes of primary hyperparathyroidism.
- Undescended parathyroid adenomas in the carotid sheath are rarely reported.
Observation:
- A 4 cm parathyroid adenoma was found within the carotid sheath.
- Initial imaging (ultrasound, SPECT/CT) mislocalized the adenoma, leading to failed surgery.
- CECT identified the adenoma posterior to the common carotid artery.
Findings:
- The patient presented with hypercalcemia and elevated parathyroid hormone levels.
- Surgical removal of the ectopic adenoma resulted in cure.
- Ectopic adenomas pose diagnostic and surgical challenges.
Implications:
- Accurate preoperative localization is crucial for successful parathyroid surgery.
- Consider ectopic locations, particularly in the carotid sheath, when standard imaging is discordant.
- Careful surgical dissection is essential to avoid missing or misdiagnosing parathyroid lesions.
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