A Case Series of Undescended Parathyroid Adenoma

Aim and background: Primary hyperparathyroidism (PHPT) affects mostly middle-aged females, and the majority of them are asymptomatic.It may be due to hyperplasia or carcinoma of adenoma(s).Undescended parathyroid glands are an infrequent cause of primary as well as secondary hyperparathyroidism (HPT); however, they are frequent in patients with recurrent HPT and with failed primary surgery.In cases of missed abnormal or ectopic parathyroid adenomas, imaging studies should precede surgery.The newer noninvasive imaging techniques have improved the preoperative (Preoperative) diagnosis of these undescended and ectopic glands.Here, we are presenting a case series of undescended parathyroid adenomas (UPAs) with the role of newer diagnostic imaging techniques and surgical procedures.Materials and methods: In our institution, we came across three cases of UPAs that were operated for PHPT.Their clinical, imaging, and surgical variables are discussed here.Results: Out of the three cases of undescended adenoma, one case was operated before for PHPT, and other two were virgin cases.Preoperative localization was done mainly with single-photon emission computed tomography (SPECT) and sestamibi scan.After the surgery for undescended adenoma, in all these cases, no complication was noted intraoperatively as well as postoperatively, and no recurrence was noted in ongoing follow-up. Conclusion:For diagnosing and treatment of UPA with PHPT, thorough knowledge of parathyroid anatomy and embryology, good imaging technique and focused surgical technique are necessary.SPECT scan is better in delineating the undescended parathyroid gland, besides magnetic resonance imaging (MRI) and sestamibi scan.