J Korean Surg Soc.  2011 Jan;80(1):67-71. 10.4174/jkss.2011.80.1.67.

Parathyroid Adenoma without Hyperparathyroidism Presenting as a Large Neck Mass

• Jeong YJ

• KMID: 2096622
• DOI: http://doi.org/10.4174/jkss.2011.80.1.67

Abstract

Parathyroid adenoma is a benign neoplasm and accounts for 80~90% of primary hyperparathyroidism. It is usually accompanied by hypercalcemia, and parathyroid adenomas with normal levels of serum parathyroid hormone (PTH) and calcium have been rarely reported in the literature. We report the case of a 16-year-old female with a large anterior neck mass who had a parathyroid adenoma without hyperparathyroidism. She underwent right thyroid lobectomy due its misinterperetation as a thyroid tumor thenultimately discovered to have been a parathyroid lesion.

Keyword

Parathyroid adenoma; Normocalcemia; Neck mass

MeSH Terms

Adolescent
Calcium
Female
Humans
Hypercalcemia
Hyperparathyroidism
Hyperparathyroidism, Primary
Neck
Parathyroid Hormone
Parathyroid Neoplasms
Thyroid Gland
Calcium
Parathyroid Hormone

Figure

• 

  Fig. 1. Cytologic findings of neck mass. Fine needle aspiration cytology was performed for neck mass with suspected thyroid tumor. The aspiration smear shows cellular and monomorphic population of small cells in three dimensional cluster and follicles. The cells has moderate amount of cytoplasm and small and round nuclei with stippled chroma-tin (Papanicolaou stain, ×400).

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  Fig. 2. Findings of the neck ultrasonography. About 4.5×3.6 cm in size, oval shaped hypoechoic mass (M) is noted in the posterior aspect of the right thyroid gland (T). Although the origin of the tumor is unclear, the boundary with the surroundings is relatively well demarcated and the tumor has proliferated solidly.

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  Fig. 3. CT of the neck. An isodense mass with internal low attenuating area is noted in the posterior aspect of the right thyroid gland. It looks exophytic mass from the thyroid gland and the trachea with the left thyroid gland are displaced to the left side.

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  Fig. 4. H&E staining. Histological sections of hematoxylin and eosin staining show a few chief cells of the parathyroid gland and a clear cells having clear cytoplasm. The findings suggest those of tumors originating in parathyroid glands (H&E stain, ×400).

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  Fig. 5. PTH staining. The cytoplasm of the tumor cells is clearly stained with PTH. The tumor is thought to be a tumor of the parathyroid gland (Immunohistochemical stain for PTH, ×400).

Reference

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