ECE2023 Eposter Presentations Calcium and Bone (99 abstracts)
Ectopic parathyroid adenoma of the upper jugulo-carotid region
Moncef Sellami 1 , Ayadi Sirine 1 , Noura Salem 1 , Zouche Imen 2 , Faten Haj Kacem Akid 3 , Mohamed Abid 3 & Ilhem Charfeddine 1
1Habib Bourguiba University Hospital, Department of Otorhinolaryngology, Head and Neck Surgery, Sfax, Tunisia; 2Habib Bourguiba University Hospital, Department of Anesthesiology, Sfax, Tunisia; 3Hedi Chaker University Hospital, Department of Endocrinology, Sfax, Tunisia
Introduction: Ectopic location of the parathyroid glands has been described in 10-15% of patients with hyperparathyroidism. Upper cervical localization is exceptional and may be missed by preoperative localization techniques. We report a rare case of parathyroid adenoma of the upper jugulo-carotid region.
Observation: A 41-year-old woman with no notable pathological history presented diffuse osteoarticular pain. Physical examination showed a right superior jugulo-carotid swelling of 3 cm of the main axis, firm, painless and mobile, without any other associated neck swelling. The laboratory workup revealed a serum calcium level of 2.7 mmol/l, an elevated parathyroid hormone level of 1109 ng/ml, and normal renal function. The neck ultrasound showed an oval 32 mm long axis, a heterogeneous upper right jugulo-carotid mass, and a normal thyroid gland. The technetium-99m-MIBI scan showed no hyper-fixation. The cervicothoracic scan showed a mass on the right neck with heterogeneous enhancement. Intraoperative exploration revealed a firm yellowish right jugulo-carotid mass of a 3 cm long axis that was easily dissected. A frozen section examination revealed a parathyroid adenoma, and this diagnosis was confirmed by the final anatomopathological examination. The postoperative course was marked by the normalization of PTH and improvement in patient quality of life.
Conclusion: The ectopic upper neck location of parathyroid adenomas is exceptional (less than 1% of adenomas). Sestamibi scintigraphy is of major importance help in the location of parathyroid glands but may be negative for the detection of these high cervical adenomas.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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