Brachiocephalic artery anomaly at the neck: importance during minimally invasive video-assisted parathyroidectomy.
A 76-year-old woman was referred to our hospital for evaluation of a parathyroid adenoma, detected on sonography. It had been located posteroinferiorly to the right thyroid lobe. Parathyroid scintigraphy confirmed the right inferior parathyroid adenoma. During physical examination of the neck, a pulsatile mass in the anterior inferior right was determined, and because of suspicion for a vascular anomaly, a computed tomography angiography was performed. The computed tomography showed that the right brachiocephalic artery ascended vertically to the level of the inferior border of right thyroid lobe and dividing into the right common carotid artery and subclavian artery at this level. Right subclavian artery after its origin brought about a curve by means of turning first posteromedially and then anterolaterally. Parathyroid adenoma remained between the right thyroid lobe, right common carotid artery, and right brachiocephalic artery. Minimally invasive video-assisted parathyroidectomy was performed and no complication appeared.
From the *Departments of Radiology, †Otolaryngology, Head and Neck Surgery, and ‡Pathology, Ataturk University Faculty of Medicine, Erzurum; and §Department of Radiology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey.
Irmak Durur
ID
Subasi
Ozgur
O
Yoruk
Sare
S
Sipal
Afak Durur
AD
Karakaya
Furkan
F
Şengöz
D000368:Aged; D000792:Angiography / Q000379:methods; D016122:Brachiocephalic Trunk / Q000002:abnormalities*; D017536:Carotid Artery, Common / Q000002:abnormalities; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D019060:Minimally Invasive Surgical Procedures; D009333:Neck / Q000098:blood supply* / Q000601:surgery; D010282:Parathyroid Neoplasms / Q000601:surgery; D016105:Parathyroidectomy / Q000379:methods*; D013348:Subclavian Artery / Q000002:abnormalities; D013961:Thyroid Gland / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods; D020535:Video-Assisted Surgery / Q000379:methods*