Ectopic parathyroid glands tend to be located in positions defined by their embryologic path during fetal development. We describe such a case of primary hyperparathyroidism due to ectopic retropharyngeal parathyroid adenoma (PTA) in a teenage girl with mild symptomatology. The initial workup with scintigraphy showed suspicious uptake above the level of thyroid gland, ultrasound, and computed tomography failed to localize an adenoma. Magnetic resonance imaging precisely localized an ectopic retropharyngeal PTA, which led to successful surgical removal.
HeathHHodgsonSFKennedyMA. Primary hyperparathyroidism: Incidence, morbidity, and potential economic impact in the community. N Engl J Med.1980; 302: 189–193.
2.
LeeVSSpritzerCE. MR imaging of abnormal parathyroid glands. Am J Roentgenol.1998; 170: 1097–1103.
3.
MillerDLCraigWOHainesGA. Retropharyngeal parathyroid adenoma: Precise preoperative localization with CT and arterial infusion of contrast material. Am J Roentgenol.1997; 169: 695–696.
4.
ChanTJLibuttiSKMcCartJA. Persistent primary hyperparathyroidism caused by adenomas identified in pharyngeal or adjacent structures. World Journal of surgery. 2003; 27 (6): 675–679.
5.
MendozaVRamírezCEspinozaAEGonzálezGAPeñaJFRamírezMEHernándezIMercadoM. Characteristics of ectopic parathyroid glands in 145 cases of primary hyperparathyroidism. Endocr Pract.2010; 24: 1–17.
6.
LevinKEClarkOH. The reasons for failure in parathyroid operations. Arch Surg.1989; 124: 911–915.
7.
WangCA. Parathyroid re-exploration: A clinical and pathological study of 112 cases. Ann Surg.1977; 186: 140–145.
8.
BensonMTDalenKMancusoAA. Congenital anomalies of the branchial apparatus: Embryology and pathologic anatomy. RadioGraphics.1992: 12: 943–960.
9.
MansbergerARJrWeiJP. Surgical embryology and anatomy of the thyroid and parathyroid glands. Surg Clin North Am.1993; 73: 727–746.
10.
ErnstO. Hyperparathyroidism: CT and MRI findings. J Radiol.2009; 90: 409–412.
11.
KangYSRosenKClarkOH. Localization of abnormal parathyroid glands of the mediastinum with MR imaging. Radiology.1993; 189: 137–141.
12.
RodriquezJMTezelmanSSipersteinAE. Localization procedures in patients with persistent or recurrent hyperparathyroidism. Arch Surg.1994; 129: 870–875.
13.
LeeVSSpnitzerCEColemanRE. The complementary roles of fast spin-echo MR imaging and double-phase Tc99 sestamibi scintigraphy for localization of hyperfunctioning parathyroid glands. Am J Roentgenol.1996; 167: 1555–1562.
