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Endocrine Abstracts (2023) 90 EP161 | DOI: 10.1530/endoabs.90.EP161

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.

Volume 90

25th European Congress of Endocrinology

Istanbul, Turkey
13 May 2023 - 16 May 2023

European Society of Endocrinology 

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