ArticleGland surgery2025
Surgical management of intrathyroidal parathyroid adenoma with nodular goiter: a case report highlighting SPECT/CT localization.
Article in Gland surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Intrathyroidal parathyroid adenomas (ITPAs) represent a rare subset of ectopic parathyroid glands, accounting for approximately 1-6% of cases. Their preoperative diagnosis remains a significant clinical challenge, as they are frequently misdiagnosed as thyroid nodules on conventional imaging such as ultrasonography and computed tomography (CT). This diagnostic difficulty is compounded in patients with concurrent thyroid pathology, such as nodular goiter. This case report aims to highlight the critical role of dual-phase technetium-99m-methoxyisobutylisonitrile ( Case Description: A 69-year-old woman with a history of longstanding bilateral thyroid nodules was referred for evaluation. Laboratory investigations revealed severe primary hyperparathyroidism (PHPT), characterized by significantly elevated parathyroid hormone (PTH; 1,656 ng/L), hypercalcemia (3.04 mmol/L), and hypophosphatemia. Initial ultrasonography and contrast-enhanced CT of the neck, while identifying multiple thyroid nodules, failed to localize any parathyroid lesion in typical or ectopic sites. Subsequent dual-phase Conclusions: This case underscores the diagnostic limitations of conventional imaging techniques for locating ITPAs, especially when masked by concomitant thyroid disease. It demonstrates that dual-phase
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