PMC10242159_01
Ectopic location of the parathyroid tumor in the presented case: A left piriform sinus inconspicuous lesion (red arrow) shows similar density to adjacent muscles on CT scan images obtained prior to intravenous contrast administration (A) compared to avid enhancement on the arterial phase images (B). Delayed (venous) imaging shows fast washout of contrast from the lesion (C), consistent with diagnosis of ectopic parathyroid adenoma.
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In addition to repeat 99Tc-sestamibi parathyroid scan, the patient underwent a four-dimensional parathyroid CT (4DCT), which identified a candidate lesion in the hypopharynx within the piriform sinus ( Figure 1 ).
Sections of pyriform mucosa show a well-circumscribed, hypercellular parathyroid tissue composed of chief cells with a thin fibrous capsule, consistent with parathyroid adenoma.
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Surgical pathology showed a 6 x 5 x 4 mm hypercellular parathyroid tissue without any thymic remnant, weighing 500 mg ( Figure 2 ).