title: Parathyroid adenoma arising within the sternocleidomastoid muscle: a rare complication of autotransplantation.
abstract: A 19-year-old patient presented with slowly enlarging, painless, left-sided cervical mass. She had a background of multiple endocrine neoplasia 2B and had undergone a total thyroidectomy for medullary thyroid carcinoma during childhood. A cervical recurrence was therefore suspected. Ultrasonographic and MRI examination revealed a well-defined lesion within the left sternocleidomastoid muscle. Further evaluation with sestamibi and single-photon emission CT revealed elevated tracer uptake within the lesion. Cytological analysis, following ultrasound-guided sampling, revealed absent staining for calcitonin and blood samples confirmed a normal serum calcitonin level; however, the serum parathyroid hormone level was elevated. Overall, summative findings were consistent with a diagnosis of a parathyroid adenoma arising within the left sternocleidomastoid muscle. Given that this is not a location for a physiological parathyroid tissue, the adenoma might have arisen within the autotransplanted parathyroid tissue, injected into the muscular sheath during thyroidectomy. The clinical, radiological and pathological features are considered in this article.
authors.affiliation: Department of Radiology, St. George's Hospital NHS Trust, London, UK.
authors.forename: Philip
authors.initials: P
authors.lastname: Touska
authors.affiliation: Department of Radiology, St. George's Hospital NHS Trust, London, UK.
authors.forename: Ahgi
authors.initials: A
authors.lastname: Srikanthan
authors.affiliation: Department of Cellular Pathology, St. George's Hospital NHS Trust, London, UK.
authors.forename: Kavita
authors.initials: K
authors.lastname: Amarasinghe
authors.affiliation: Department of Radiology, St. George's Hospital NHS Trust, London, UK Department of Head & Neck Radiology, University College Hospital, London, UK.
authors.forename: Susan
authors.initials: S
authors.lastname: Jawad
mesh_terms: D000236:Adenoma / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D000328:Adult; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D009377:Multiple Endocrine Neoplasia / Q000150:complications* / Q000601:surgery*; D019042:Muscle Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging / Q000601:surgery; D010282:Parathyroid Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D014182:Transplantation, Autologous / Q000009:adverse effects*; D055815:Young Adult