Korean Journal of Head & Neck Oncology (대한두경부종양학회지)

The Korean Society for Head and Neck Oncology (대한두경부종양학회)
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A Case of Intra-thyroidal Parathyroid Adenoma Confirmed by Intraoperative Near-infrared Autofluorescence

수술 중 근적외선 자가형광으로 확인된 갑상선 내부의 부갑상선 선종 1예

  • Dong Gyu Choi (Department of Otolaryngology-Head and Neck Surgery, Kosin University College of Medicine) ;
  • Jun Sang Cha (Department of Otolaryngology-Head and Neck Surgery, Kosin University College of Medicine) ;
  • Yeong Joon Kim (Department of Otolaryngology-Head and Neck Surgery, Kosin University College of Medicine) ;
  • Hyoung Shin Lee (Department of Otolaryngology-Head and Neck Surgery, Kosin University College of Medicine) ;
  • Kang Dae Lee (Department of Otolaryngology-Head and Neck Surgery, Kosin University College of Medicine)
  • 최동규 (고신대학교 의과대학 이비인후-두경부외과학교실) ;
  • 차준상 (고신대학교 의과대학 이비인후-두경부외과학교실) ;
  • 김영준 (고신대학교 의과대학 이비인후-두경부외과학교실) ;
  • 이형신 (고신대학교 의과대학 이비인후-두경부외과학교실) ;
  • 이강대 (고신대학교 의과대학 이비인후-두경부외과학교실)
  • Received : 2023.02.06
  • Accepted : 2023.03.11
  • Published : 2023.05.30
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Abstract

In general, the anatomical location and number of parathyroid glands are well known, but they are often found in a variety of locations, making it difficult to find parathyroid glands during surgery. Besides Intra-thyroidal parathyroid adenoma is extremely rare case, and it is harder to identify in surgery. We encountered a 51-year-old patient with a thyroid nodule. The results of the additional blood test and the Tc-99m MIBI were combined to determine that the left lower lobe parathyroid adenoma was highly likely. This patient was treated with left thyroid lobectomy with parathyroid identification using Near-infrared (NIR) imaging. Afterwards, the biopsy confirmed that it was a parathyroid adenoma, and has since been monitored through outpatient observation without any problem. We present this rare case with a review of related literatures.

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References

  1. Sebag F, Shen W, Brunaud L, Kebebew E, Duh Q-Y, Clark OH. Intraoperative parathyroid hormone assay and parathyroid reoperations. Surgery. 2003;134:1049-1055. https://doi.org/10.1016/j.surg.2003.08.007
  2. Lee SW, Park H, Shin JM, Lee YM, Park JH, Koh YW, et al. Clinical Analysis of Parathyroid Adenoma with Primary Hyperparathyroidism. Korean J Otorhinolaryngol-Head Neck Surg. 2006;49:72-78.
  3. Kim YB, Choi JY, Lee GH, Lee MC. A Case of Pancreatitis Associated with Hyperfunctioning Intrathyroidal Parathyroid Adenoma. Korean J Otorhinolaryngol-Head Neck Surg. 2014; 57:539-542. https://doi.org/10.3342/kjorl-hns.2014.57.8.539
  4. Feliciano DV. Parathyroid pathology in an intrathyroidal position. Am J Surg. 1992;164:496-500. https://doi.org/10.1016/S0002-9610(05)81188-2
  5. Kim SW, Seo YS, Lee HS, Kim Y, Ahn YC, Lee KD. Usefulness of Autofluorescence Video-Monitoring to Enhanced Localization of Parathyroid Glands. Korean J Otorhinolaryngol-Head Neck Surg. 2020 63):586-593. https://doi.org/10.3342/kjorl-hns.2019.00556
  6. Kobayashi T, Man-I M, Shin E, Kikkawa N, Kawahara K, Kurata A, et al. Hyperfunctioning intrathyroid parathyroid adenoma: report of two cases. Surg Today. 1999;29:766-768. https://doi.org/10.1007/BF02482323
  7. Wang C. Hyperfunctioning intrathyroid parathyroid gland: a potential cause of failure in parathyroid surgery. J R Soc Med. 1981;74:49-52. https://doi.org/10.1177/014107688107400109
  8. Morris MA, Saboury B, Ahlman M, Malayeri AA, Jones EC, Chen CC, et al. Parathyroid Imaging: Past, Present, and Future. Front Endocrinol (Lausanne). 2022;12:760419.
  9. Devcic Z, Jeffrey RB, Kamaya A, Desser TS. The elusive parathyroid adenoma: techniques for detection. Ultrasound Q. 2013;29:179-187. https://doi.org/10.1097/RUQ.0b013e3182a1ba6f
  10. Goodman A, Politz D, Lopez J, Norman J. Intrathyroid parathyroid adenoma: incidence and location-the case against thyroid lobectomy. Otolaryngol Head Neck Surg. 2011;144:867-871. https://doi.org/10.1177/0194599811400366
  11. Kim SW, Song SH, Lee HS, Noh WJ, Oak CH, Ahn YC, et al. Intraoperative Real-Time Localization of Normal Parathyroid Glands With Autofluorescence Imaging. J Clin Endocrinol Metab. 2016;101:4646-4652. https://doi.org/10.1210/jc.2016-2558
  12. Kim SW, Lee HS, Ahn YC, Park CW, Jeon SW, Kim CH, et al. Near-Infrared Autofluorescence Image-Guided Parathyroid Gland Mapping in Thyroidectomy. J Am Coll Surg. 2018;226:165-172. https://doi.org/10.1016/j.jamcollsurg.2017.10.015