Localization of Parathyroid Adenoma on Ultrasound: Topography and Features
Typical Locations of Adenoma
According to Hagen-Ansert (2023), sonographic variants of parathyroid adenoma locations include:
- along the posterior edge of the upper pole of the thyroid gland;
- below (inferolateral to) the thyroid gland — in this position, a complex cystic adenoma may be found.
Shape and Size
As adenomas enlarge, they acquire a more elongated, tubular (tubelike), or bilobar shape. Small adenomas are usually less than 3 cm, whereas large ones can reach 5 cm or more in length (Hagen-Ansert, 2023).
Sonographic Variants
| Variant | Description |
|---|---|
| Classic | Located along the posterior edge of the upper pole of the thyroid gland |
| With Calcification | Irregularly shaped adenoma with calcification and acoustic shadowing |
| Complex Cystic | Located below the thyroid gland |
Additional Localization Methods
For preoperative localization of parathyroid adenoma in patients with primary hyperparathyroidism, 99mTc-sestamibi SPECT/CT is used alongside ultrasound (Patel et al., cited in AIUM, 2023). [clarification needed] comparative diagnostic value of methods not provided in fragments.
Frequently asked questions
Where is parathyroid adenoma most commonly located on ultrasound?
Along the posterior edge of the upper pole of the thyroid gland, as well as below the thyroid gland (Hagen-Ansert, 2023).
What sizes are characteristic of adenomas?
Small adenomas are usually less than 3 cm, while large ones are 5 cm or more in length (Hagen-Ansert, 2023).
How does the shape of an adenoma change as it enlarges?
The adenoma becomes more elongated, tubular, or bilobar in shape (Hagen-Ansert, 2023).
Can an adenoma have calcifications or a cystic component?
Yes, there are irregularly shaped adenomas with calcification and acoustic shadowing, as well as complex cystic adenomas (Hagen-Ansert, 2023).
What methods are used for preoperative localization besides ultrasound?
99mTc-sestamibi SPECT/CT in primary hyperparathyroidism (Patel et al., cited in AIUM, 2023).