title: Parathyroid adenoma in third pharyngeal pouch cyst as a rare case of primary hyperparathyroidism.
abstract: The primitive thymus and inferior parathyroid derive from the third branchial cleft. During embryonic development, these structures descend, reaching their final localisation. Third branchial cleft anomalies present usually as a fistula, abscess or cyst. However, there are no reports on parathyroid adenomas in the literature other than as a morphological possibility. We describe the case of a 47-year-old man, who had been diagnosed with arterial hypertension and who presented with a cervical mass at the edge of the lower third of the sternocleidomastoid muscle. On ultrasonography, the mass had a cystic walled appearance. Laboratory analysis only revealed an intact parathyroid hormone level of 140.5 pg/ml. Sestamibi imaging showed a probable parathyroid adenoma in the anterior mediastinum. During surgery, a tract running from beyond the superior thyroid pedicle to the superior mediastinum was dissected and removed. In the inferior end of the tract, a brown mass was visible. Pathological examination revealed a thymus cyst surrounding a parathyroid adenoma. The primal alteration was the lack of division between the thymus and inferior parathyroid gland, and the prompt prevention of their development. In the case of our patient, a parathyroid adenoma had grown by chance.
authors.affiliation: La Princesa University Hospital, Madrid, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Salido
authors.forename: J
authors.initials: J
authors.lastname: Gómez-Ramírez
authors.forename: J M
authors.initials: JM
authors.lastname: Bravo
authors.forename: E
authors.initials: E
authors.lastname: Martín-Pérez
authors.forename: G
authors.initials: G
authors.lastname: Fernández-Díaz
authors.forename: J L
authors.initials: JL
authors.lastname: Múñoz de Nova
authors.forename: J
authors.initials: J
authors.lastname: Auza
authors.forename: E
authors.initials: E
authors.lastname: Larrañaga
mesh_terms: D000236:Adenoma / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D003287:Contrast Media; D003560:Cysts / Q000150:complications / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006801:Humans; D006961:Hyperparathyroidism / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010282:Parathyroid Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D016105:Parathyroidectomy / Q000379:methods*; D010608:Pharyngeal Diseases / Q000150:complications / Q000000981:diagnostic imaging; D035583:Rare Diseases; D018570:Risk Assessment; D017256:Technetium Tc 99m Sestamibi; D013908:Thoracotomy / Q000379:methods; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler / Q000379:methods
chemical_list: D003287:Contrast Media; D017256:Technetium Tc 99m Sestamibi