Secondary hyperparathyroidism induced parathyroid adenoma masquerading as a solitary thyroid nodule-a case report

Authors

  • Mukesh Kumar Yadav Department of ENT and HNS, Command Hospital Airforce, Bangalore, Karnataka, India http://orcid.org/0000-0001-6204-8876
  • Pankaj Kumar Sahu Department of ENT and HNS, Command Hospital Airforce, Bangalore, Karnataka, India
  • Sanjay Kumar Department of ENT and HNS, Command Hospital Airforce, Bangalore, Karnataka, India
  • Roohie Singh Department of ENT and HNS, Command Hospital Airforce, Bangalore, Karnataka, India
  • Praveen Kumar Paramasivam Department of ENT and HNS, Command Hospital Airforce, Bangalore, Karnataka, India
  • Natasha Dogra Department of Pathology, Command Hospital Airforce, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20220818

Keywords:

Parathyroid adenoma, Follicular neoplasm of thyroid, SHPT, Vitamin D deficiency

Abstract

Parathyroid adenoma is associated with both primary and secondary hyperparathyroidism (SHPT). Identification of the adenoma requires a combination of clinical evidence, imaging information and cytological findings due to the challenging distinction between thyroid and parathyroid lesions. Sometimes ultrasound and even fine needle aspiration studies cannot distinguish this lesion from thyroid lesions. We present a case who was incidentally detected to have nodule in the (R) lobe of thyroid on CE-MRI. FNAC was suggestive of follicular neoplasm so managed as right hemithyroidectomy but the final diagnosis was made as parathyroid adenoma on the basis of histopathological examination and immunohistochemistry. Patient was evaluated retrospectively utilizing serum PTH levels, 24 hours urine calcium levels, inorganic phosphorus and USG KUB which turn out to be vitamin D deficiency induced SHPT and was managed with vit D3 supplements.

Author Biographies

Mukesh Kumar Yadav, Department of ENT and HNS, Command Hospital Airforce, Bangalore, Karnataka, India

Departement of ENT & HNS, Command hospital Airforce Banaglore. Doctor

Pankaj Kumar Sahu, Department of ENT and HNS, Command Hospital Airforce, Bangalore, Karnataka, India

Departement of ENT & HNS, Command hospital Airforce Banaglore. HOD & Senior Advisor

Sanjay Kumar, Department of ENT and HNS, Command Hospital Airforce, Bangalore, Karnataka, India

Departement of ENT & HNS, Command hospital Airforce Banaglore. Doctor

References

Muppidi V, Meegada SR, Rehman A. Secondary Hyperparathyroidism, Treasure Island (FL): StatPearls Publishing; 2022;32491754.

Ahmad R, Hammond JM. Primary, secondary, and tertiary hyperparathyroidism. Otolaryngol Clin N Am. 2004;37:701-13.

Frasoldati A, Pesenti M. Detection and diagnosis of parathyroid incidentalomas during thyroid sonography. J Clin Ultrasound. 1999;27(9):492-8.

Mirhosaini SM, Amani S, Fereidani R. Parathyroid Adenoma Completely Impacted within the Thyroid Gland: A Case Report. J Clin of Diagn Res. 2016;10(6):MD01-2.

Absher KJ, Truong LD, Khurana KK, Ramzy I. Parathyroid cytology: avoiding diagnostic pitfalls. Head Neck. 2002;24(2):157-64.

Sung S, Sagi S. Cytomorphologic features distinguishing Bethesda category IV thyroid lesions from parathyroid. Cyto J. 2017;14:10.

Downloads

Published

2022-03-24

Issue

Section

Case Reports