Right thyroid hemiagenesis with adenoma and hyperplasia of parathyroid glands -case report
1 Surgical Oncology clinic, Institute for Oncology and Radiology of Serbia, Pasterova 14, Belgrade, 11000, Serbia
2 Department of Surgery, Kuma Hospital, 8-2-35, Shimoyamate-dori, Chuo-ku, Kobe, 650-0011, Japan
3 Department of Clinical Research, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
4 Department of Pathology, Institute for Oncology and Radiology of Serbia, Pasterova 14, Belgrade, 11000, Serbia
5 University of Belgrade School of Medicine, Belgrade, 11000, Serbia
6 Institute for Oncology and Radiology of Serbia, Pasterova 14, Belgrade, 11000, Serbia
BMC Endocrine Disorders 2012, 12:29 doi:10.1186/1472-6823-12-29Published: 13 November 2012
Thyroid hemiagenesis is a rare anomaly, more commonly seen on the left side (ratio 4:1) and in females (ratio 3:1). The first to describe this anomaly was Handfield Jones in 1852.
We present a 66 year old female patient with right thyroid hemiagenesis, parathyroid adenoma on the side of hemiagenesis and parathyroid hyperplasia on the contralateral side. The patient had neck pain and was diagnosed as Hashimto thyroiditis with hyperparathyroidism. Parathyroid hormone, thyroglobulin antibodies (Tg-Ab) and thyroid peroxidase antibodies (TPO-Ab) were elevated. Neck ultrasound and technetium 99mTc-methoxyisobutyl isonitrile (MIBI) scintigraphy confirmed the right thyroid hemiagenesis, but not adenoma of parathyroid glands. Intraoperatively, right thyroid hemiagenesis was confirmed and left loboistmectomy was performed with removal of left inferior hyperplastic parathyroid gland. Postoperative PTH (parathyroid hormone) levels were within normal range. Five months after the operation PTH level was elevated again with calcium values at the upper limit. MIBI scintigraphy was performed again which showed increased accumulation of MIBI in the projection of the right parathyroid gland. Surgical reexploration of the neck and excision of the right upper parathyroid adenoma was performed which was located behind cricoid laryngeal cartilage. After surgery a normalization of calcium and PTH occured.
From available literature we have not found the case that described parathyroid adenoma on the side of thyroid hemiagenesis,with parathyroid hyperplasia on the contralateral side.