PMC6525286_01
A: Radiograph bilateral both knee suggestive of genu valgum. B: radiograph bilateral both hand suggestive of acro-osteolysis. C: radiograph chest PA view suggestive of subchondral resorption on the distal ends of the clavicle. D: Tc 99 m Sestamibi scan suggestive of right inferior parathyroid adenoma.
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Radiograph of bilateral both knee joints was suggestive of genu valgum (Fig. 1A). A skeletal survey (Fig. 1B & C) revealed generalized osteopenia, subchondral resorption on the distal ends of the clavicle and acro-osteolysis of distal phalanges. A Technetium (99mTc) sestamibi scan was suggestive of right inferior parathyroid adenoma (Fig. 1D).
A: Bean shaped nodule partly embedded in lower pole of right lobe of thyroid. B: Gross specimen of parathyroid. C: Histopathology of parathyroid gland showing encapsulated, cellular, homogenous lesions composed of chief cells in delicate capillary network. D: Histopathology of thymus.
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After preoperative evaluation, she underwent parathyroidectomy under general anesthesia, which was identified as a bean shaped nodule partly embedded in lower pole of right lobe of thyroid peri-operatively (Fig. 2A). The tumor was with few small nodules with surrounding adipose tissue (Fig. 2B). Histopathology of the specimen revealed encapsulated, cellular, homogenous lesions composed of chief cells in delicate capillary suggestive of parathyroid adenoma (Fig. 2C). However, the histopathology of thymus was normal (Fig. 2D).