Int J Thyroidol.  2021 May;14(1):42-45. 10.11106/ijt.2021.14.1.42.

A Case of Hyperparathyroidism Caused by Intrathyroidal Parathyroid Adenoma

  • 1Department of Otorhinolaryngology-Head & Neck Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
  • 2Institute of Health Science, Gyeongsang National University School of Medicine, Jinju, Korea


Hyperparathyroidism is a common endocrine disorder, but intrathyroidal parathyroid adenoma is extremely rare. We report a on a case of hyperparathyroidism caused by intrathyroidal parathyroid adenoma. This case is important in that it affects an effective test for the diagnosis of intrathyroidal parathyroid adenoma, and shows the decision of the treatment process and the results.


Hyperparathyroidism; Ectopic parathyroid; Parathyroid adenoma; Intrathyroidal parathyroid adenoma


  • Fig. 1 Computed tomography of the neck. The scan with contrast enhancement shows a heterogeneous soft tissue mass, clearly defined, within the left thyroid lobe (white arrows). (A) Axial view. (B) Coronal view.

  • Fig. 2 Thyroid ultrasonography showed 1.77×1.13×3.32 cm hypoechoic nodule in left thyroid gland.

  • Fig. 3 Technesium (Tc)-99m sestamibi parathyroid scan. Early and delayed scintigrams reveal focal accumulation of increased radiotracer uptake in the left lobe of the thyroid.

  • Fig. 4 Gross photo of specimen. (A) Exposed left side of thyroid tissue (arrowheads). (B) The gross pathology specimen of left thyroid.

  • Fig. 5 Histopathologic findings of left thyroid gland. Microscopic findings show well-encapsulated parathyroid adenoma inside the normal thyroid tissue. (A) Hematoxylin and Eosin (H&E) stain, ×40, (B) H&E stain, ×100 (arrows). The tumor cells showed diffuse strong positivity for GATA3, but absence of staining for TTF1. (C) GATA3 immune stain, ×40. (D) TTF1 immune stain, ×40.



1. Phitayakorn R, McHenry CR. 2006; Incidence and location of ectopic abnormal parathyroid glands. Am J Surg. 191(3):418–23. DOI: 10.1016/j.amjsurg.2005.10.049. PMID: 16490559.
2. Policeni BA, Smoker WR, Reede DL. 2012; Anatomy and embryology of the thyroid and parathyroid glands. Semin Ultrasound CT MR. 33(2):104–14. DOI: 10.1053/j.sult.2011.12.005. PMID: 22410358.
3. Goodman A, Politz D, Lopez J, Norman J. 2011; Intrathyroid parathyroid adenoma: incidence and location--the case against thyroid lobectomy. Otolaryngol Head Neck Surg. 144(6):867–71. DOI: 10.1177/0194599811400366. PMID: 21493318.
4. Paek SH, Kim SJ, Choi JY, Lee KE. 2018; Clinical usefulness of intraoperative parathyroid hormone monitoring for primary hyperparathyroidism. Ann Surg Treat Res. 94(2):69–73. DOI: 10.4174/astr.2018.94.2.69. PMID: 29441335. PMCID: PMC5801330.
5. Taniegra ED. 2004; Hyperparathyroidism. Am Fam Physician. 69(2):333–9. PMID: 14765772.
6. Rossi ED, Mule A, Zannoni GF, Fadda G. 2004; Asymptomatic intrathyroidal parathyroid adenoma. Report of a case with a cytologic differential diagnosis including thyroid neoplasms. Acta Cytol. 48(3):437–40. DOI: 10.1159/000326400. PMID: 15192966.
7. Steward DL, Danielson GP, Afman CE, Welge JA. 2006; Parathyroid adenoma localization: surgeon-performed ultrasound versus sestamibi. Laryngoscope. 116(8):1380–4. DOI: 10.1097/01.mlg.0000227957.06529.22. PMID: 16885740.
8. Khati N, Adamson T, Johnson KS, Hill MC. 2003; Ultrasound of the thyroid and parathyroid glands. Ultrasound Q. 19(4):162–76. DOI: 10.1097/00013644-200312000-00002. PMID: 14730259.
9. Fernandez KL, Turer P, Spiegler EJ, Singer JA. 2002; The use of sestamibi imaging in parathyroid hyperplasia. Clin Nucl Med. 27(12):865–7. DOI: 10.1097/00003072-200212000-00003. PMID: 12607864.
10. Feliciano DV. 1992; Parathyroid pathology in an intrathyroidal position. Am J Surg. 164(5):496–500. DOI: 10.1016/S0002-9610(05)81188-2. PMID: 1443376.
Full Text Links
  • IJT
export Copy
  • Twitter
  • Facebook
Similar articles
Copyright © 2022 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: