Case Report

Nonadenomatous Thymic Unencapsulated Parathyroid Tissue as a Cause of Persistent Primary Hyperparathyroidism

Authors: JOHN P. WEI MD, RUSSELL B. TIPPINS MD, RAGUNATHA N. RAO MD, GEORGE J. BURKE MD, ARLIE R. MANSBERGER JR MD

Abstract

ABSTRACT: Primary hyperparathyroidism may be caused by ectopic intrathymic parathyroid adenomas or hyperplastic parathyroid glands. The association of the ectopic inferior parathyroid glands and the thymus is due to their common embryologic origin from the third pharyngeal pouch. We report a case of primary hyperparathyroidism due to an unusual pathologic parathyroid gland formation: nonadenomatous thymic unencapsulted parathyroid tissue. Two unsuccessful neck explorations revealed only two normal parathyroid glands within the cervical area. Radiologic imaging studies failed to localize an ectopic parathyroid adenoma. Mediastinal exploration and thymectomy showed one small focus of unencapsulated hypercellular parathyroid tissue expanding peripherally along the septa of thymic adipose tissue. The hyperparathyroidism resolved with the surgical procedure.

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References