Skip to main content
SpringerLink
Log in

Ectopic Parathyroid Adenoma

  • Chapter
  • First Online:
Hyperparathyroidism

  • 813 Accesses

Abstract

Ectopic parathyroid glands can significantly impact morbidity associated with parathyroid surgery, including the need for reoperation. Due to their longer migratory path during embryogenesis, the inferior parathyroid glands have a greater probability of becoming ectopic. While most ectopic parathyroid glands are accessible through a cervical incision, some require access to the mediastinum via either thoracotomy or a minimally invasive approach. Preoperative localization of parathyroid adenomas correlates with successful surgical resection and can alter the operative approach depending on ectopic gland location. Most surgical centers perform some combination of preoperative and/or intraoperative localization techniques prior to reoperation for persistent or recurrent primary hyperparathyroidism (PHPT).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 16.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Mendoza V, Ramírez C, Espinoza AE, González GA, Peña JF, Ramírez ME, et al. Characteristics of ectopic parathyroid glands in 145 cases of primary hyperparathyroidism. Endocr Pract. 2010;16(6):977–81.

    Article  PubMed  Google Scholar 

  2. Shen W, Düren M, Morita E, et al. Reoperation for persistent or recurrent primary hyperparathyroidism [with discussion]. Arch Surg. 1996;131:861–9.

    Article  PubMed  CAS  Google Scholar 

  3. Kaplan EL, Yashiro T, Salti G. Primary hyperparathyroidism in the 1990s: choice of surgical procedures for this disease. Ann Surg. 1992;215(4):300–17.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  4. Phitayakorn R, McHenry CR. Incidence and location of ectopic abnormal parathyroid glands. Am J Surg. 2006;191(3):418–22; discussion 422–3.

    Article  PubMed  Google Scholar 

  5. Arnault V, Beaulieu A, Lifante JC, Sitges Serra A, Sebag F, Mathonnet M, et al. Multicenter study of 19 aortopulmonary window parathyroid tumors: the challenge of embryologic origin. World J Surg. 2010;34(9):2211–6.

    Article  PubMed  Google Scholar 

  6. Bagul A, Patel HP, Chadwick D, Harrison BJ, Balasubramanian SP. Primary hyperparathyroidism: an analysis of failure of parathyroidectomy. World J Surg. 2014;38(3):534–41.

    Article  PubMed  CAS  Google Scholar 

  7. Nawrot I, Chudziński W, Ciąćka T, Barczyński M, Szmidt J. Reoperations for persistent or recurrent primary hyperparathyroidism: results of a retrospective cohort study at a tertiary referral center. Med Sci Monit. 2014;20:1604–12.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Thompson NW, Eckhauser FE, Harness JK. The anatomy of primary hyperparathyroidism. Surgery. 1982;92:814–21.

    PubMed  CAS  Google Scholar 

  9. Young WF. The Netter collection of medical illustrations. 2nd ed. Philadelphia: Elsevier; 2011.

    Google Scholar 

  10. Wang CA. Parathyroid re-exploration. A clinical and pathological study of 112 cases. Ann Surg. 1977;186(2):140–5.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  11. Jaskowiak N, Norton JA, Alexander HR, Doppman JL, Shawker T, Skarulis M, et al. A prospective trial evaluating a standard approach to reoperation for missed parathyroid adenoma. Ann Surg. 1996;224(3):308–20.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  12. Doppman JL, Skarulis MC, Chen CC, Chang R, Pass HI, Fraker DL, et al. Parathyroid adenomas in the aortopulmonary window. Radiology. 1996;201(2):456–62.

    Article  PubMed  CAS  Google Scholar 

  13. Gouveia S, Rodrigues D, Barros L, Ribeiro C, Albuquerque A, Costa G, Carvalheiro M. Persistent primary hyperparathyroidism: an uncommon location for an ectopic gland – case report and review. Arq Bras Endocrinol Metabol. 2012;56(6):393–403.

    Article  PubMed  Google Scholar 

  14. Billingsley KG, Fraker DL, Doppman JL, et al. Localization and operative management of undescended parathyroid adenomas in patients with persistent primary hyperparathyroidism. Surgery. 1994;116:982–90.

    PubMed  CAS  Google Scholar 

  15. Daliakopoulos SI, Chatzoulis G, Lampridis S, Pantelidou V, Zografos O, Ioannidis K, et al. Gamma probe-assisted excision of an ectopic parathyroid adenoma located within the thymus: case report and review of the literature. J Cardiothorac Surg. 2014;9:62.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Axelrod D, Sisson JC, Cho K, et al. Appearance of ectopic undescended inferior parathyroid adenomas on technetium-99m-sestamibi scintigraphy. Arch Surg. 2003;138:1214–8.

    Article  PubMed  Google Scholar 

  17. Smith JR, Oates ME. Radionuclide imaging of the parathyroid glands: patterns, pearls, and pitfalls. Radiographics. 2004;24(4):1101–15.

    Article  PubMed  Google Scholar 

  18. Said SM, Cassivi SD, Allen MS, Deschamps C, Nichols 3rd FC, Shen KR, Wigle DA. Minimally invasive resection for mediastinal ectopic parathyroid glands. Ann Thorac Surg. 2013;96(4):1229–33.

    Article  PubMed  Google Scholar 

Download references

Conflicts of Interest

All authors state that they have no conflicts of interest.

Author information

Authors and Affiliations

  1. Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Department of Internal Medicine, Mayo College of Medicine, Mayo Clinic, Rochester, MN, USA

    Jad G. Sfeir MD & Matthew T. Drake MD, PhD

Authors
  1. Jad G. Sfeir MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Matthew T. Drake MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Matthew T. Drake MD, PhD .

Editor information

Editors and Affiliations

  1. Mayo Clinic, Rochester, Minnesota, USA

    Ann E. Kearns

  2. Mayo Clinic, Rochester, Minnesota, USA

    Robert A. Wermers

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Mayo Foundation for Medical Education and Research

About this chapter

Cite this chapter

Sfeir, J.G., Drake, M.T. (2016). Ectopic Parathyroid Adenoma. In: Kearns, A., Wermers, R. (eds) Hyperparathyroidism. Springer, Cham. https://doi.org/10.1007/978-3-319-25880-5_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-25880-5_8

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-25878-2

  • Online ISBN: 978-3-319-25880-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation