PATHOLOGICAL INTRATHYROIDAL PARATHYROID-GLANDS

Background. Parathyroid glands originate from the third and fourth bra nchial pouches and migrate caudally to their final positions. Aberrati ons during migration result in anomalous locations. Intrathyroidal loc ation is not common. Methods. We reviewed cervical explorations perfor med from 1974 to 1993 in hyperparathyroidism patients. Results. We fou nd pathological intrathyroidal glands in six patients. Three patients had adenomas (left superior, left inferior and right inferior glands), The hyperplastic glands were left inferior in one patient and right i nferior in the remaining two. Intraoperative diagnosis was made in thr ee cases in which palpation of the thyroid gland showed a nodule that was suspected to be the parathyroid missing gland. In three patients i t was a finding in thyroidectomy or hemithyroidectomy specimens, two o f them with associated thyroid nodular disease. Conclusions. Ipsilater al thyroidotomy on the side of a palpable thyroid mass or blind hemith yroidectomy are justified if a presumably pathological intrathyroidal gland is suspected, when all other sites in the neck have been exclude d.