title: Intrathyroidal parathyroid hyperplasia in tertiary hyperparathyroidism.
abstract: We report herein a case of intrathyroidal parathyroid hyperplasia in a patient with tertiary hyperparathyroidism. The patient was recommended for parathyroidectomy due to sustained hypercalcemia after kidney transplantation. Preoperative radiologic evaluations showed a benign-looking thyroid mass and three enlarged parathyroid glands. Intraoperative intact parathyroid hormone (iPTH) level and frozen biopsy results indicated a missed parathyroid gland after immediate subtotal parathyroidectomy. Then, a secondary partial resection of thyroid including the thyroid nodule was performed. An excised intrathyroid nodule was diagnosed to be parathyroid hyperplasia by frozen biopsy, and intraoperative iPTH level abruptly decreased. A benign-looking thyroidal mass in patients with secondary or tertiary hyperparathyroidism should be carefully evaluated considering the possibility of an intrathyroidal parathyroid hyperplasia.
authors: Department of Surgery, Chung-Ang University Hospital, Seoul, Republic of Korea.
authors: Byung Seup
authors: BS
authors: Kim
authors: Department of Pathology, Chung-Ang University Hospital, Seoul, Republic of Korea Chung-Ang University College of Medicine, Seoul, Republic of Korea.
authors: Han Suk
authors: HS
authors: Ryu
authors: Department of Surgery, Chung-Ang University Hospital, Seoul, Republic of Korea kgiseup@naver.com.
authors: Kyung Ho
authors: KH
authors: Kang
authors: Department of Surgery, Chung-Ang University Hospital, Seoul, Republic of Korea.
authors: Sung Jun
authors: SJ
authors: Park