成人における甲状腺内傍甲状腺腫瘍（オンコ細胞型）：診断上の課題 - 事例報告

R Bouatay^1,2, F Farhat¹, Jamel Koubaa^1,2

¹ENT & Head and Neck Surgery department at Fattouma Bourguiba hospital in Monastir, Tunisia.

International journal of surgery case reports

|January 16, 2026

要旨

Introduction And Importance:

Intrathyroidal parathyroid adenoma ((IPAs) is a rare localization of parathyroid adenomas, potentially leading to both diagnostic and therapeutic challenges. We report a case of primary hyperparathyroidism revealed by bone and joint pain, with an atypical intrathyroidal location of the oncocytic parathyroid adenoma.

Case Presentation:

A 72-year-old woman was admitted for evaluation and management of chronic bone and joint pain. Laboratory tests revealed hypercalcemia associated with elevated parathyroid hormone (PTH) levels. Cervical ultrasound showed a 3 cm right lobar nodule classified as EU-TIRADS 3. Technetium-99 m sestamibi (MIBI) scintigraphy demonstrated intense uptake at the same location, raising suspicion of either thyroid or parathyroid origin. The patient underwent a right loboisthmectomy. Definitive histological analysis confirmed a 3 cm intrathyroid parathyroid adenoma. Postoperative evolution was favorable, with normalization of serum calcium and PTH levels.

Clinical Discussion:

Despite their rarity, IPAs hold significant clinical importance, as their atypical location within the thyroid parenchyma can lead to failed surgical explorations if not properly considered.

Conclusion:

This case illustrates the rarity and diagnostic complexity of ectopic intrathyroidal oncocytic parathyroid adenomas, which can lead to failed surgical explorations. This is highlights the importance of a multimodal diagnostic approach including ultrasound, MIBI scintigraphy, and histopathology for optimal management.

キーワード:

異所性局在葉切除 MIBIシンチグラフィー副甲状腺腺腫原発性副甲状腺機能亢進症

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