Right thyroid hemiagenesis with adenoma and hyperplasia of parathyroid glands -case report

BMC Endocrine Disorders

Radan Dzodic⁴  Igor Djurisic²  Gordana Pupic¹  Ziv Radisavljevic³  Marko Buta²  Yasuhiro Ito⁵  Merima Oruci⁶ 

[1] Department of Pathology, Institute for Oncology and Radiology of Serbia, Pasterova 14, Belgrade, 11000, Serbia;Surgical Oncology clinic, Institute for Oncology and Radiology of Serbia, Pasterova 14, Belgrade, 11000, Serbia;Department of Clinical Research, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA;University of Belgrade School of Medicine, Belgrade, 11000, Serbia;Department of Surgery, Kuma Hospital, 8-2-35, Shimoyamate-dori, Chuo-ku, Kobe, 650-0011, Japan;Institute for Oncology and Radiology of Serbia, Pasterova 14, Belgrade, 11000, Serbia

关键词: Hyperparathyroidism;    Parathyroid hyperplasia;    Parathyroid adenoma;    Right thyroid hemiagenesis;   

Others  :  1086073
DOI  :  10.1186/1472-6823-12-29

 received in 2012-08-08, accepted in 2012-10-29,  发布年份 2012

【 摘 要 】

Background

Thyroid hemiagenesis is a rare anomaly, more commonly seen on the left side (ratio 4:1) and in females (ratio 3:1). The first to describe this anomaly was Handfield Jones in 1852.

Case presentation

We present a 66 year old female patient with right thyroid hemiagenesis, parathyroid adenoma on the side of hemiagenesis and parathyroid hyperplasia on the contralateral side. The patient had neck pain and was diagnosed as Hashimto thyroiditis with hyperparathyroidism. Parathyroid hormone, thyroglobulin antibodies (Tg-Ab) and thyroid peroxidase antibodies (TPO-Ab) were elevated. Neck ultrasound and technetium 99mTc-methoxyisobutyl isonitrile (MIBI) scintigraphy confirmed the right thyroid hemiagenesis, but not adenoma of parathyroid glands. Intraoperatively, right thyroid hemiagenesis was confirmed and left loboistmectomy was performed with removal of left inferior hyperplastic parathyroid gland. Postoperative PTH (parathyroid hormone) levels were within normal range. Five months after the operation PTH level was elevated again with calcium values at the upper limit. MIBI scintigraphy was performed again which showed increased accumulation of MIBI in the projection of the right parathyroid gland. Surgical reexploration of the neck and excision of the right upper parathyroid adenoma was performed which was located behind cricoid laryngeal cartilage. After surgery a normalization of calcium and PTH occured.

Conclusion

From available literature we have not found the case that described parathyroid adenoma on the side of thyroid hemiagenesis,with parathyroid hyperplasia on the contralateral side.

【 授权许可】

   
2012 Oruci et al.; licensee BioMed Central Ltd.

【 图 表 】

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