A Rare Case of Thyroid Ectopia Mimicking Parathyroid Adenoma in a 19-Year-Old Filipino Female


Authors : Gerard John D. Gaspillo; Daniella Agbayani

Volume/Issue : Volume 10 - 2025, Issue 8 - August


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DOI : https://doi.org/10.38124/ijisrt/25aug973

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Abstract : Introduction: Parathyroid adenoma (PA) is the leading cause of primary hyperparathyroidism, but rarely, present without any clinical manifestations. Reported cases of asymptomatic PA are few, with limited knowledge about their behavior and management.  Case: The 19-year-old patient presented with a left anterior neck mass. Baseline bloodwork including serum calcium levels, thyroid and parathyroid function tests were normal. Further examination, consisting of ultrasound, CT scan, and parathyroid scintigraphy, demonstrated a solid mass posteroinferior of the left thyroid lobe suggesting exophytic left thyroid mass, parathyroid adenoma, or malignancy. Lobectomy of ectopic thyroid lobe was done. On pathologic examination, nodular hyperplasia was noted with immunoreactivity to TTF-1 and not to Chromogranin A and Synaptophysin consistent with a follicular nodular disease with hyperplastic features, arising from a sequestered thyroid nodule.  Conclusion: PA without hyperparathyroidism are rare and diagnosis is a challenge. While imaging modalities aid in the diagnosis, pathologic examinations are essential in confirming the definite diagnosis.

Keywords : Thyroid Ectopia, Parathyroid Adenoma, Filipino, Female.

References :

  1. Pradnyandari, N. P. T., & Budhiarta, A. A. G. (2022). Asymptomatic hypercalcemia due to bilateral parathyroid adenoma: A case report. International Journal of Research and Review, 9(7), 611–616. https://doi.org/10.52403/ijrr.20220766
  2. Al Hassan, M. S., El Ansari, W., Issa, N., Darweesh, A., & Abdelaal, A. (2023). Severe hypercalcemia secondary to parathyroid adenoma: Series of four consecutive cases at a tertiary care hospital in Qatar. International Journal of Surgery Case Reports, 109, 108560. https://doi.org/10.1016/j.ijscr.2023.108560
  3. PAPANIKOS, V., PAPADODIMA, E., BANTOUNA, D., PAPARODIS, R. D., LIVADAS, S., ANGELOPOULOS, N., & KARVOUNIS, E. (2024). HYPERCALCEMIC CRISIS DUE TO A GIANT INTRATHYROIDAL PARATHYROID ADENOMA, WITH POSTSURGICAL SEVERE HYPOCALCEMIA AND HUNGRY BONE SYNDROME: A CASE REPORT. CLINICAL PRACTICE, 14(1), 179–187. HTTPS://DOI.ORG/10.3390/CLINPRACT14010015
  4. Sanker V, Mohamed A, Pranala M, Tharakan V. A Unique Presentation of Ectopic Thyroid Tissue: Case Report and Management Principles. Cureus. 2022 Sep 3;14(9):e28717. doi: 10.7759/cureus.28717. PMID: 36204041; PMCID: PMC9527565.
  5. Santangelo, G., Pellino, G., De Falco, N., Esposito, D., Bianco, F., Calise, F., & De Palma, G. D. (2016). Prevalence, diagnosis and management of ectopic thyroid glands. International Journal of Surgery, 28(Suppl 1), S1–S6. HTTPS://DOI.ORG/10.1016/J.IJSU.2015.12.043
  6. Zhang, Q., Zhou, L., Li, W., & Xu, Y. (2025). Ectopic thyroid tissue in the airway: a case report. BMC Pulmonary Medicine, 25(1). HTTPS://DOI.ORG/10.1186/S12890-025-03514-2
  7. Meng, Z., Lou, S., Tan, J., Jia, Q., Zheng, R., Liu, G., Zhu, M., He, Q., & Li, D. (2014). Scintigraphic detection of dual ectopic thyroid tissue: experience of a Chinese tertiary hospital. PLoS ONE, 9(4), e95686. HTTPS://DOI.ORG/10.1371/JOURNAL.PONE.0095686
  8. Palot Manzil, F. F., Eichhorn, J., & Vattoth, S. (2023). Synchronous Ectopic Thyroid Gland and Ectopic Parathyroid Adenoma on 99mTc-Sestamibi Scintigraphy and Correlative Imaging. Journal of nuclear medicine technology, 51(3), 263–264. HTTPS://DOI.ORG/10.2967/JNMT.122.265249
  9. Ng, F. H., Yung, K. S., & Luk, W. H. (2020). Ectopic Submandibular Parathyroid Adenoma by Tc-99m Sestamibi SPECT/CT Localization. Journal of clinical imaging science, 10, 61. https://doi.org/10.25259/JCIS_125_2020

Introduction: Parathyroid adenoma (PA) is the leading cause of primary hyperparathyroidism, but rarely, present without any clinical manifestations. Reported cases of asymptomatic PA are few, with limited knowledge about their behavior and management.  Case: The 19-year-old patient presented with a left anterior neck mass. Baseline bloodwork including serum calcium levels, thyroid and parathyroid function tests were normal. Further examination, consisting of ultrasound, CT scan, and parathyroid scintigraphy, demonstrated a solid mass posteroinferior of the left thyroid lobe suggesting exophytic left thyroid mass, parathyroid adenoma, or malignancy. Lobectomy of ectopic thyroid lobe was done. On pathologic examination, nodular hyperplasia was noted with immunoreactivity to TTF-1 and not to Chromogranin A and Synaptophysin consistent with a follicular nodular disease with hyperplastic features, arising from a sequestered thyroid nodule.  Conclusion: PA without hyperparathyroidism are rare and diagnosis is a challenge. While imaging modalities aid in the diagnosis, pathologic examinations are essential in confirming the definite diagnosis.

Keywords : Thyroid Ectopia, Parathyroid Adenoma, Filipino, Female.

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Paper Submission Last Date
30 - November - 2025

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