Journal of Postgraduate Medicine
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CASE REPORT
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Year : 2019  |  Volume : 65  |  Issue : 4  |  Page : 237-240  

Retropharyngeal ectopic parathyroid adenoma versus lymph node: Problem solving with CT neck angiogram

PP Batchala, PK Rehm 
 Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, VA, USA

Correspondence Address:
P P Batchala
Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, VA
USA

A 66-year-old female underwent preoperative evaluation for primary hyperparathyroidism. Ultrasound (US) neck and technetium (Tc)-99m-sestamibi planar scintigraphy were negative, but single photon emission computed tomography/computed tomography (SPECT/CT) demonstrated a tracer-avid retropharyngeal nodule compatible with parathyroid adenoma (PTA). A retrospective review of CT neck angiogram (CTA) and neck magnetic resonance imaging (MRI) performed 4 months earlier for stroke evaluation revealed arterial phase hyperenhancing retropharyngeal tissue, which had been dismissed as a nonpathological lymph node. “Polar vessel sign” seen in two-thirds of PTA was also present on retrospective review of the CTA. The concordant findings between SPECT/CT and CTA were indicative of a solitary undescended ectopic PTA in the retropharyngeal space, an uncommon location. A successful surgical cure was achieved after minimally invasive parathyroidectomy. This case highlights the retropharyngeal space as an important ectopic site of PTA, limitation of US, and Tc-99m-sestamibi planar scintigraphy in identifying retropharyngeal PTA. We also discuss the role of CT and MRI and the challenge in differentiating retropharyngeal PTA from a lymph node.


How to cite this article:
Batchala P P, Rehm P K. Retropharyngeal ectopic parathyroid adenoma versus lymph node: Problem solving with CT neck angiogram.J Postgrad Med 2019;65:237-240


How to cite this URL:
Batchala P P, Rehm P K. Retropharyngeal ectopic parathyroid adenoma versus lymph node: Problem solving with CT neck angiogram. J Postgrad Med [serial online] 2019 [cited 2021 Apr 11 ];65:237-240
Available from: https://www.jpgmonline.com/article.asp?issn=0022-3859;year=2019;volume=65;issue=4;spage=237;epage=240;aulast=Batchala;type=0


 
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