Nakao Erina, Kimura Tomohiko, Iwamoto Hideyuki, Tatsumi Fuminori, Kaneto Hideaki
Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, Kurashiki, JPN.
Cureus. 2025 Jun 23;17(6):e86572. doi: 10.7759/cureus.86572. eCollection 2025 Jun.
Parathyroid glands typically exist in pairs on the posterior surface of the thyroid, and primary hyperparathyroidism (PHPT) is often caused by adenomas in these locations. However, ectopic parathyroid glands may occasionally develop in unusual sites. We present a case of a 71-year-old female patient who exhibited gradual increases in both serum calcium and parathyroid hormone (PTH) levels, along with the development of osteoporosis, suggesting the presence of PHPT. Routine examination, including ultrasonography, sometimes fails to identify an ectopic parathyroid adenoma. In this case, further investigation using methoxyisobutylisonitrile (MIBI) scintigraphy and contrast-enhanced CT revealed an ectopic parathyroid adenoma located in the posterior part of the esophagus. After that, left parathyroidectomy was performed. Left parathyroid weight was 610 mg, and its size was 23 × 10 × 4 mm. Pathological examination confirmed the diagnosis of ectopic parathyroid adenoma. After the surgery, serum PTH and calcium levels were normalized. This case underscores the importance of considering ectopic parathyroid adenomas when ultrasonography fails to identify the lesion and highlights the importance of MIBI scintigraphy in such cases.
甲状旁腺通常成对存在于甲状腺后侧，原发性甲状旁腺功能亢进症（PHPT）常由这些部位的腺瘤引起。然而，异位甲状旁腺偶尔会在不寻常的部位发育。我们报告一例71岁女性患者，其血清钙和甲状旁腺激素（PTH）水平逐渐升高，并伴有骨质疏松症，提示存在PHPT。包括超声检查在内的常规检查有时无法识别异位甲状旁腺腺瘤。在该病例中，使用甲氧基异丁基异腈（MIBI）闪烁扫描和增强CT进行进一步检查，发现一个位于食管后部的异位甲状旁腺腺瘤。此后，进行了左侧甲状旁腺切除术。左侧甲状旁腺重量为610mg，大小为23×10×4mm。病理检查确诊为异位甲状旁腺腺瘤。手术后，血清PTH和钙水平恢复正常。该病例强调了在超声检查未能识别病变时考虑异位甲状旁腺腺瘤的重要性，并突出了MIBI闪烁扫描在此类病例中的重要性。
