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Ectopic parathyroid adenoma located inside the hypoglossal nerve
Author(s) -
Karvounaris Dimitrios C.,
Symeonidis Nikolaos,
Triantafyllou Apostolos,
Flaris Nicolaos,
Sakadamis Athanasios
Publication year - 2010
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.21215
Subject(s) - medicine , parathyroid adenoma , hypoglossal nerve , lesion , paresis , nodule (geology) , facial nerve , histopathology , anatomy , adenoma , radiology , surgery , pathology , tongue , paleontology , biology
Background Intraneural parathyroid adenomas are extremely rare, with only 9 cases of intravagal adenomas reported. We report the first case of an ectopic parathyroid adenoma located within the hypoglossal nerve. Methods and Results A 62‐year‐old woman presented with a palpable nodule in the right submandibular area, reduced bone mass, and elevated calcium and parathormone levels. Preoperative investigation with neck ultrasound and MRI did not provide a definitive diagnosis, whereas sestamibi scan showed slightly increased radiotracer accumulation in the same area. Intraoperatively, the right hypoglossal nerve was found to course through the lesion and, despite the attempt to salvage it, most of its fibers were transected. Histopathology confirmed the presence of a parathyroid adenoma inside the trunk of a nerve. Postoperatively, calcium and parathormone levels decreased but right hypoglossal nerve paresis was noted. Conclusion This unique case emphasizes the variability of parathyroid anatomy and the difficulties faced by the surgeon when treating this disease process. © 2009 Wiley Periodicals, Inc. Head Neck, 2010