Parathyroid adenoma

Case contributed by Dr Hein Els


Palpable nodule on the right side of neck. Previous left thyroid lobectomy for a benign condition.

Patient Data

Age: 70
Gender: Male

Circumscribed  echogenic nodule posterior to and separate from the right lobe of the thyroid. The lesion has internal Doppler, but is not hypervascular. No calcification.  No adenopathy in the remainder of the neck.


Circumscribed mixed density nodule posterior to the right lobe of the thyroid. A thin tissue plane separates the lesion from adjacent vasculature, muscles and the right lobe of the thyroid. No calcification or cystic component. Mixed enhancement pattern. 


Large nodule: parathyroid adenoma with no atypia or malignancy.

Immunohistochemistry: thyroglobulin negative; synaptophysin and chromogranin positive.

Smaller tissue sample: thyroid tissue with features of multinodular goiter. No malignancy.

Images courtesy of Dr. Reenee Munbodh

Case Discussion

Imaging most compatible with a parathyroid adenoma. The differential of an enlarged lymph node, an eccentric thyroid nodule, or a nerve sheath tumor were considered unlikely. 

Lab results concordant with imaging suspicion of a parathyroid adenoma. The serum calcium and parathyroid hormone levels were raised.

With thanks to Drs. D van der Merwe & A. Macdonald.

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Case information

rID: 46638
Published: 15th Sep 2016
Last edited: 14th Aug 2019
System: Head & Neck
Inclusion in quiz mode: Included

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