Parathyroid Adenoma Arising from Autotransplanted Parathyroid Tissue in Sternocleidomastoid Muscle: A Case Report with Review of the Literature

Abstract

Total parathyroidectomy followed by autotransplantation in patients with renal hyperparathyroidism to prevent hypoparathyroidism is a relatively common surgical procedure. However, parathyroid adenoma arising in autotransplanted parathyroid tissue in patients with secondary hyperparathyroidism is very rare. To date, less than 20 such cases have been reported in the English literature.   Here we report a case of a 47-year-old African-American male with a history of end stage renal disease on dialysis undergoing a total parathyroidectomy and autotransplantation in 2001, presenting with severe hyperparathyroidism and enlarged transplanted parathyroid tissue 6 years later.  The palpable mass at the site of autotransplantation was excised.  Grossly, the cut surface of the mass appeared brown-tan.  Microscopically, the mass was well circumscribed and composed of sheets of small, round and relatively uniform cells, morphologically consistent with chief cells.  No adipose tissue or oxyphil cells were found inside the mass.  Cellular atypia was not identified.  Based on the above morphological features and the patient’s history, the diagnosis of parathyroid adenoma arising from autotransplanted tissue was established.  This case illustrates that parathyroid adenoma arising from autograph can cause hyperparathyroidism.