Ectopic parathyroid adenoma in the pyriform sinus

Head Neck. 2017 Oct;39(10):E110-E113. doi: 10.1002/hed.24878. Epub 2017 Jul 25.

Abstract

Background: Ectopic parathyroid glands may complicate the surgical approach to primary hyperparathyroidism. We describe a rare ectopic parathyroid location, the pyriform sinus.

Methods: Three patients, 2 after prior unsuccessful parathyroid exploration, were found to have ectopic parathyroid adenomas in the pyriform sinus. Two cases were identified by 4D-CT of the neck. The other was localized by a technetium 99m sestamibi single photon emission CT (SPECT). In each case, office endoscopy confirmed the lesions. The patients were treated by either transoral laser or robotic resection of the parathyroid adenoma.

Results: After surgery, the patients had resolution of their hyperparathyroidism.

Conclusion: Ectopic parathyroid adenomas in the pyriform sinus are rare, but should be considered in those patients who have had a failed neck exploration and in those who undergo 4D-CT scanning or SPECT scanning.

Keywords: 4D-CT; ectopic; parathyroid; surgery; transoral.

Publication types

  • Case Reports

MeSH terms

  • Adenoma / surgery*
  • Aged
  • Choristoma*
  • Female
  • Four-Dimensional Computed Tomography / methods
  • Humans
  • Hyperparathyroidism, Primary / etiology
  • Hyperparathyroidism, Primary / surgery
  • Laryngoscopy
  • Lasers, Gas / therapeutic use
  • Middle Aged
  • Parathyroid Glands / pathology*
  • Parathyroid Glands / surgery
  • Parathyroid Neoplasms / pathology*
  • Parathyroid Neoplasms / surgery
  • Pyriform Sinus / pathology*
  • Pyriform Sinus / surgery
  • Robotic Surgical Procedures / methods
  • Technetium Tc 99m Sestamibi
  • Tomography, Emission-Computed, Single-Photon / methods

Substances

  • Technetium Tc 99m Sestamibi