title: Right thyroid hemiagenesis with adenoma and hyperplasia of parathyroid glands -case report.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Surgical Oncology clinic, Institute for Oncology and Radiology of Serbia, Pasterova 14, Belgrade, 11000, Serbia. merimaoruci@hotmail.com.
authors.forename: Merima
authors.initials: M
authors.lastname: Oruci
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ito
authors.forename: Marko
authors.initials: M
authors.lastname: Buta
authors.forename: Ziv
authors.initials: Z
authors.lastname: Radisavljevic
authors.forename: Gordana
authors.initials: G
authors.lastname: Pupic
authors.forename: Igor
authors.initials: I
authors.lastname: Djurisic
authors.forename: Radan
authors.initials: R
authors.lastname: Dzodic