Primary Hyperparathyroidism is known to present with protean manifestations leading to
misdiagnosis in the initial stages of the
disease. Inability to locate the
adenoma in an ectopic
parathyroid gland may further delay the
diagnosis of these cases. Aberrant migration during development may
lead to intrathyroidal or other ectopic locations of
parathyroid glands. This may
lead to their
misdiagnosis as a
thyroid nodule or failure to locate parathyroids during
surgery. Similarity in cytological picture between
thyroids and parathyroids may further complicate
diagnosis by
fine needle aspiration cytology. Nuclear imaging
scintigraphy accurately localizes the
tumor in 90% of cases and simplifies the surgical management. We encountered three such cases with the
parathyroid gland adenomas in ectopic locations in which pre-operative nuclear imaging played a major
role.