Parathyroid adenoma

Case contributed by Maulik S Patel
Diagnosis almost certain

Presentation

A female presented with a history of generalized bone pain. The serum parathyroid hormone is elevated. She was referred for a neck ultrasound to rule out/rule in a parathyroid adenoma.

Patient Data

Age: 35 years
Gender: Female
x-ray

There is a presence of generalized osteopenia. However, there is no bone lesion/ fracture. The intervertebral disc spaces are maintained.

ultrasound

There is a well-defined, homogeneous lesion posterior-inferior to the right lobe of the thyroid gland. It is hypoechoic in comparison to the thyroid gland. There is no calcification/ cystic space in it. The lesion elevates the echogenic posterior capsule of the thyroid gland. Few flow signals are present in the lesion.

Case Discussion

A female presented with generalized bone pain. Laboratory investigation showed an elevated serum parathyroid hormone. The ultrasound shows a well-defined, solid, vascular lesion posterior to the thyroid gland. The lesion is very likely to be a parathyroid adenoma in view of the clinical background.

Surgical excision was done and histopathology confirmed the lesion being a parathyroid adenoma.

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