Right thyroid hemiagenesis with adenoma and hyperplasia of parathyroid glands -case report

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...

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Bibliographic Details
Published in:BMC endocrine disorders 2012-11, Vol.12 (1), p.29-29, Article 29
Main Authors: Oruci, Merima, Ito, Yasuhiro, Buta, Marko, Radisavljevic, Ziv, Pupic, Gordana, Djurisic, Igor, Dzodic, Radan
Format: Article
Language:English
Subjects:
Adenoma
Agenesis
Analysis
Antibodies
Case Report
Case studies
Consent
Diagnosis
Hormones
Hospitals
Hyperparathyroidism
Hyperplasia
Hypothyroidism
Oncology
Parathyroid adenoma
Parathyroid hormone
Parathyroid hyperplasia
Prevalence studies (Epidemiology)
Right thyroid hemiagenesis
Surgery
Thyroid diseases
Thyroid gland
Ultrasonic imaging
Viral antibodies
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Summary: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.
ISSN:1472-6823
1472-6823
DOI:10.1186/1472-6823-12-29