Endocrine Abstracts

We present a 66 year old patient with right thyroid hemiagenesis and double parathyroid adenoma one on the side of hemiagenesis and the other on the side of present left lobe. The patient came to our Clinic because of pain in the neck and was diagnosed a primary hyperparathyroidism with elevated parathyroid hormon as well as Hashimoto thyroiditis with high level of Tg and TPO antibodies. Ultrasound and technetium sestamibi scintigraphy determined the absence of the right lobe but not adenoma of parathyroid glands. The patient underwent exploration of the neck which confirmed right thyroid hemiagenesis. Left loboistmectomy was performed with excision of left inferior parathyroid adenoma. Five months after the operation, parathormon level was still increased with calcium values at the upper limit. Sestamibi scintigraphy was performed again which showed increased accumulation of MIBI in the projection of the right lower parathyroid gland. We performed reexploration of the neck and excision of the right upper parathyroid adenoma wich was located behind cricoid laryngeal cartilage. After surgery we observed a normalization calcium and parathormon value. Thyroid hemiagenesis is a rare anomaly, more common in female (ratio 3:1) and with predominace of left lobe involvment (ratio 4:1). The first to describe this anomaly was Handfield Jones in 1852. From available literature we have not found the case that described double parathyroid adenoma which one on the side of thyroid hemiagenesis.

Hemiagenesis, double parathyroid adenoma.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.