title: Parathyroid incidentaloma detected during thyroid sonography - prevalence and significance beyond images.
abstract: BACKGROUND
  Parathyroid incidentaloma (PTI) designates a nodule discovered incidentally during thyroid sonography, and whose location and aspect suggests an abnormal parathyroid. Our aim was to assess the prevalence of PTI, their functional characteristics and to identify the factors correlated with their presence.
  
  
  METHODS
  We recorded all patients detected with PTI between January 2009 and December 2011, in our department. Serum calcium, parathyroid hormone (PTH), thyroid stimulating hormone (TSH), free thyroine (FT4) and anti thyroid peroxidase antibodies (anti-TPO Ab) were measured.
  
  
  RESULTS
  From a total of 2662 thyroid ultrasounds, 32 patients were identified with PTI (prevalence 1.2%). The diagnosis of a functional parathyroid adenoma was confirmed in 12 patients (37.5%). There was no significant difference in size, location, echogenicity or vascular pattern between the functioning adenomas and the other PTI. The only parameter correlated with the non functioning lesion was the multinodular pattern of the thyroid (multinodular goiter or macronodular autoimmune thyroiditis).
  
  
  CONCLUSIONS
  Although rare, the ultrasound identification of an image suggestive for a pathological parathyroid gland requires the evaluation of the functioning character of the lesion, more than one third PTI being hyperfunctional. The concomitance of a nodular goiter decreases the probability of a primary hyperparathyroidism.
authors.affiliation: Endocrinology Department, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Romania. cghervan@yahoo.com
authors.forename: Cristina
authors.initials: C
authors.lastname: Ghervan
authors.forename: Alina
authors.initials: A
authors.lastname: Silaghi
authors.forename: Codruţa
authors.initials: C
authors.lastname: Nemeş
mesh_terms: D000236:Adenoma / Q000098:blood supply / Q000000981:diagnostic imaging*; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006044:Goiter, Nodular / Q000000981:diagnostic imaging; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000175:diagnosis; D033162:Incidental Findings; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010280:Parathyroid Glands / Q000000981:diagnostic imaging*; D010282:Parathyroid Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D016606:Thyroid Nodule / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D055815:Young Adult