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Clinical Observation
January 1998

Endoscopic Laser Excision of Ectopic Pyriform Sinus Parathyroid Adenoma

Author Affiliations

From the General Surgery Service (Drs Stojadinovic, Shriver, York, and Jaques), the Head and Neck Service (Dr Casler), and the Pathology Service (Dr Gaertner), Walter Reed Army Medical Center, Washington, DC.

Arch Surg. 1998;133(1):101-103. doi:10.1001/archsurg.133.1.101

Ectopic parathyroid adenomas are one of the causes of failed neck exploration for primary hyperthyroidism. Location of the ectopic gland in the pyriform recess is rarely described premortem. Moreover, removal of such an ectopically located gland using an endoscopic approach, thereby avoiding potentially morbid repeated open neck explorations, to our knowledge, has not been described.

A 68-year-old woman presented with symptoms of fatigue and cramping abdominal discomfort. Serum calcium and parathyroid hormone levels were abnormally elevated, and urinary calcium excretion levels were normal, confirming a diagnosis of primary hyperparathyroidism.