Case 1 Female in 80’s. Primary
hyperparathyroidism secondary to adenoma. Hypercalcaemia, urgent neck exploration, 1.4g parathyroid up to
45mm in size, with 40mm blood containing cyst. This lesion was a benign parathyroid adenoma that was
part cystic with some
without criteria for malignancy.
Case 2 Male in 60’s, mass located high in carotid sheath, for 12 years weighing
48g. Parathyroid adenoma
with clear cell (water clear) change, see higher power views
here. Other possible diagnoses were paraganglioma and
possible parathyroid carcinoma, or metastatic renal cell carcinoma. The preferred diagnosis was parathyroid adenoma
with water clear change
Case 3 Female late 70’s parathyroid excision. An oncocytic parathyroid
adenoma, This lesion while quite
atypical in its cytology did
not show malignant features.
Case 4 Female early 30’s parathyroidectomy 3 years ago, now continuing hyperparathyroidism, tissue in
scar and mid trachea level VI. Tissue taken for frozen section. Benign parathyroid implants/
parathyromatosis , see also views here of nodules of parathyroid tissue
embedded in skeletal muscle . Parathyroid
carcinoma is in the differential diagnosis. This case was originally diagnosed as a parathyroid carcinoma and
a radical neck dissection performed. It was only after there was a recurrence in the thorax on mediastinoscopy that
the final diagnosis of benign implantation due to secondary hyperparathyroidism was made.
Case 5 Female, mid 70’s, primary hyperparathyroidism, mediastinal
parathyroid, thoracotomy, specimen 26g, 70x42x23mm, solid with central cyst up to 15mm. Solid area
circulated. This was diagnosed as a
benign parathyroid adenoma see
here provided the other glands were confirmed to be of normal size.
Exceptionally large and ectopically located in the mediastinum but a 70mm mediastinal gland has been previously
reported – Ann Ital Chir 2009 Jan-Feb 80(1):55-9. Although this
lesion has fat within it there is not enough fat for a diagnosis
of lipoadenoma. The Mayo Clinic apparently requires >50% fat for a lipoadenoma; others have not quantified it.
Lipoadenomas can contain other elements similar lto a hamartoma