{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T20:37:22Z","timestamp":1791405442510,"version":"4.3.3"},"reference-count":53,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2021,8,7]],"date-time":"2021-08-07T00:00:00Z","timestamp":1628294400000},"content-version":"vor","delay-in-days":218,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ectopic parathyroid gland is not uncommon, and is associated with primary hyperparathyroidism. Giant parathyroid adenoma (PA) and concurrent presence of enlarged thyroid nodule increases the probability of ectopic location. The combination of a giant PA that is ectopic (within the strap muscle) in the neck is very rare, especially in cases with no previous surgery. The rare histopathological findings of the current case, water clear cell parathyroid adenoma (WCCPA), could explain the patient's presentation, since it has low endocrine function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>\n                      A 56-year-old Qatari female on routine visit to primary health care physician for hypertension, was incidentally discovered to be hypercalcemic and was referred to the emergency department of our institution. Neck ultrasound showed a thyroid nodule on the left side, but\n                      <jats:sup>99m<\/jats:sup>\n                      Tc-sestamibi scintigraphy identified a left PA. FNAC of the thyroid nodule showed that it was a colloid nodule. She underwent left hemithyroidectomy and excision of left PA. Intraoperatively, the PA was giant and in the sternohyoid muscle. Intraoperative monitoring of intact PTH (IOiPTH) confirmed successful excision.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Ectopic giant parathyroid adenoma is rare especially with the intramuscular location in sternohyoid muscle in the neck without previous neck surgeries. The presence of thyroid nodule could be a precipitating factor for migration of the PA. Preoperative assessment with the radiological image is crucial for diagnosis but sometimes fail to localized the PA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Giant asymptomatic PA with long standing low function before hyperfunctioning should raise the suspicion of WCCPA. If diagnosis is confirmed, metastasis from a clear cell renal cell carcinoma should be ruled out.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2021.106295","type":"journal-article","created":{"date-parts":[[2021,8,9]],"date-time":"2021-08-09T22:33:40Z","timestamp":1628548420000},"page":"106295","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Water clear cell ectopic non-iatrogenic giant parathyroid adenoma in sternohyoid muscle with thyroid nodule and asymptomatic hypercalcemia due to primary hyperparathyroidism"],"prefix":"10.1097","volume":"86","author":[{"given":"Walla","family":"Mohamed","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walid","family":"El Ansari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed S.","family":"Al Hassan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rayan M.","family":"Sibira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdelrahman","family":"Abusabeib","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-17-20260114","first-page":"5069","article-title":"Imaging ectopic parathyroid adenomas. A literature review","volume":"30","author":"Mor\u00f3n","year":"2019","journal-title":"Rev. Colomb. Radiol"},{"key":"R2-17-20260114","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1007\/s12105-008-0088-8","article-title":"Parathyroid adenoma","volume":"2","author":"Wieneke","year":"2008","journal-title":"Head Neck Pathol"},{"key":"R3-17-20260114","doi-asserted-by":"crossref","first-page":"S408","DOI":"10.4103\/2230-8210.104110","article-title":"A challenging case of an ectopic parathyroid adenoma","volume":"16","author":"Panchani","year":"2012","journal-title":"Indian J. Endocrinol. Metab"},{"key":"R4-17-20260114","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1177\/0194599815619625","article-title":"Reoperative parathyroidectomy: overly descended superior adenoma","volume":"154","author":"Duke","year":"2016","journal-title":"Otolaryngol. Head Neck Surg"},{"key":"R5-17-20260114","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1007\/s00268-012-1773-z","article-title":"Incidence and localization of ectopic parathyroid adenomas in previously unexplored patients","volume":"37","author":"Roy","year":"2013","journal-title":"World J. Surg"},{"key":"R6-17-20260114","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1177\/0194599816630711","article-title":"Parathyroid 4D CT and scintigraphy: what factors contribute to missed parathyroid lesions?","volume":"154","author":"Galvin","year":"2016","journal-title":"Otolaryngol. Head Neck Surg"},{"key":"R7-17-20260114","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1111\/j.1445-2197.2006.03931.x","article-title":"Reoperative parathyroid surgery: the importance of ectopic location and multigland disease","volume":"76","author":"Gough","year":"2006","journal-title":"ANZ J. Surg"},{"key":"R8-17-20260114","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1097\/00000658-199609000-00007","article-title":"A prospective trial evaluating a standard approach to reoperation for missed parathyroid adenoma","volume":"244","author":"Jaskowiak","year":"1996","journal-title":"Ann. Surg"},{"key":"R9-17-20260114","doi-asserted-by":"crossref","first-page":"1478","DOI":"10.1359\/JBMR.050502","article-title":"Ectopic parathyroid tumor in the sternohyoid muscles: supernumerary gland in a patient with MEN type 1","volume":"20","author":"Miura","year":"2005","journal-title":"J. Bone Miner. Res"},{"key":"R10-17-20260114","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1055\/s-0032-1327628","article-title":"Ectopic parathyroid glands and their anatomical, clinical and surgical implications","volume":"120","author":"Noussios","year":"2012","journal-title":"Exp. Clin. Endocrinol. Diabetes"},{"key":"R11-17-20260114","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1001\/archsurg.2011.837","article-title":"Impact of localization studies and clinical scenario in patients with hyperparathyroidism being evaluated for reoperative neck surgery","volume":"146","author":"Shin","year":"2011","journal-title":"Arch. Surg"},{"key":"R12-17-20260114","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1186\/s13256-019-2257-7","article-title":"Giant parathyroid adenoma: a case report and review of the literature","volume":"13","author":"Al-Hassan","year":"2019","journal-title":"J. Med. Case Rep"},{"key":"R13-17-20260114","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1016\/j.ijscr.2017.01.064","article-title":"Surgical management of a giant parathyroid adenoma through minimal invasive parathyroidectomy. A case report","volume":"31","author":"Sahsamanis","year":"2017","journal-title":"Int. J. Surg. Case Rep"},{"key":"R14-17-20260114","doi-asserted-by":"crossref","first-page":"1726","DOI":"10.1097\/00005537-200110000-00010","article-title":"Parathyroid cysts: a case report and review of the literature","volume":"111","author":"Fortson","year":"2001","journal-title":"Laryngoscope"},{"key":"R15-17-20260114","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1097\/00000658-199609000-00007","article-title":"A prospective trial evaluating a standard approach to reoperation for missed parathyroid adenoma","volume":"224","author":"Jaskowiak","year":"1996","journal-title":"Ann. Surg"},{"key":"R16-17-20260114","doi-asserted-by":"crossref","first-page":"1519","DOI":"10.1007\/s00405-011-1776-7","article-title":"Recurrence of secondary hyperparathyroidism in patients after total parathyroidectomy with autotransplantation: technical and therapeutic aspects","volume":"269","author":"Agha","year":"2012","journal-title":"Eur. Arch. Otorhinolaryngol"},{"key":"R17-17-20260114","first-page":"614","article-title":"Parathyroid autotransplantation in forty-four patients with primary hyperparathyroidism: the role of thallium scanning","volume":"100","author":"McCall","year":"1986","journal-title":"Surgery"},{"key":"R18-17-20260114","first-page":"275","article-title":"Large clear cell adenoma of the parathyroid in a patient with MEN-1 syndrome. Ultrastructural study of the tumour exhibiting unusual RER formations","volume":"45","author":"Kovacs","year":"1994","journal-title":"Acta Biol. Hung"},{"key":"R19-17-20260114","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1177\/1066896917701577","article-title":"Water clear cell adenoma of the parathyroid gland: a forgotten cause of primary hyperparathyroidism","volume":"25","author":"El Hussein","year":"2017","journal-title":"Int. J. Surg. Pathol"},{"key":"R20-17-20260114","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1507\/endocrj.51.207","article-title":"A rare case of primary hyperparathyroidism with clear cell adenoma","volume":"51","author":"Kanda","year":"2004","journal-title":"Endocr. J"},{"key":"R21-17-20260114","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.ijsu.2020.10.034","article-title":"The SCARE 2020 guideline: updating consensus Surgical Case Report (SCARE) guidelines","volume":"84","author":"Agha","year":"2020","journal-title":"Int. J. Surg"},{"key":"R22-17-20260114","first-page":"160","article-title":"Water clear cell parathyroid adenoma: case report and literature review","volume":"3","author":"Tassone","year":"2014","journal-title":"Thyroid Disord. Ther"},{"key":"R23-17-20260114","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1007\/s12022-012-9211-1","article-title":"Water-clear parathyroid adenoma: report of two cases and literature review","volume":"23","author":"Bai","year":"2012","journal-title":"Endocr. Pathol"},{"key":"R24-17-20260114","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1002\/dc.22806","article-title":"Cytologic findings of a clear cell parathyroid lesion","volume":"41","author":"Papanicolau-Sengos","year":"2013","journal-title":"Diagn. Cytopathol"},{"key":"R25-17-20260114","doi-asserted-by":"crossref","first-page":"1803","DOI":"10.1172\/JCI113275","article-title":"Parathyroid hormone like protein from human renal carcinoma cells. Structural and functional homology with parathyroid hormone","volume":"80","author":"Strewler","year":"1987","journal-title":"J. Clin. Invest"},{"key":"R26-17-20260114","first-page":"1072","article-title":"Water-clear cell adenoma of the parathyroid, a case report with immunohistochemistry and electron microscopy","volume":"119","author":"Grenko","year":"1995","journal-title":"Arch. Pathol. Lab. Med"},{"key":"R27-17-20260114","first-page":"316","article-title":"Clear cell adenoma of the parathyroid gland: a rare and misleading lesion","volume":"19","author":"Bequeret","year":"1999","journal-title":"Ann. Pathol"},{"key":"R28-17-20260114","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1053\/hupa.2001.26478","article-title":"Intrathyroidal water-clear cell parathyroid adenoma: a case report","volume":"32","author":"Dundar","year":"2001","journal-title":"Hum. Pathol"},{"key":"R29-17-20260114","doi-asserted-by":"crossref","first-page":"256","DOI":"10.5858\/2001-125-0256-SWCCDP","article-title":"Synchronous water-clear cell double parathyroid adenomas a hitherto uncharacterized entity?","volume":"125","author":"Kuhel","year":"2001","journal-title":"Arch. Pathol. Lab. Med"},{"key":"R30-17-20260114","first-page":"39","article-title":"Water-clear cell adenoma of the parathyroid gland: a rare entity","volume":"47","author":"Prasad","year":"2004","journal-title":"Indian J. Pathol. Microbiol"},{"key":"R31-17-20260114","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1007\/s00595-007-3484-x","article-title":"Water-clear cell parathyroid adenoma causing primary hyperparathyroidism in a patient with neurofibromatosis type 1: report of a case","volume":"37","author":"Kodama","year":"2007","journal-title":"Surg. Today"},{"key":"R32-17-20260114","doi-asserted-by":"crossref","first-page":"872","DOI":"10.1016\/j.jfma.2012.10.015","article-title":"Water-clear cell parathyroid adenoma in a patient with acute pancreatitis","volume":"113","author":"Chou","year":"2014","journal-title":"J. Formos. Med. Assoc"},{"key":"R33-17-20260114","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1016\/j.ijscr.2013.07.016","article-title":"Waterclear cell adenoma: a rare form of hyperparathyroidism","volume":"4","author":"Piggot","year":"2013","journal-title":"Int. J. Surg. Case Rep"},{"key":"R34-17-20260114","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1308\/003588413X13511609957533","article-title":"Primary hyperparathyroidism with water clear cell content: the impact of histological diagnosis on clinical management and outcome","volume":"95","author":"Ezzat","year":"2013","journal-title":"Ann. R. Coll. Surg. Engl"},{"key":"R35-17-20260114","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1007\/s00595-013-0568-7","article-title":"Water-clear cell adenoma associated with primary hyperparathyroidism: report of a case","volume":"44","author":"Murakami","year":"2014","journal-title":"Surg. Today"},{"key":"R36-17-20260114","first-page":"7169564","article-title":"Intrathyroidal clear cell tumor of parathyroid origin with review of literature","volume":"2016","author":"Pirela","year":"2016","journal-title":"Case Rep. Pathol"},{"key":"R37-17-20260114","doi-asserted-by":"crossref","first-page":"243","DOI":"10.5152\/turkjsurg.2017.3574","article-title":"An unusual cause of hypercalcemic crisis: water-clear cell double parathyroid adenoma","volume":"33","author":"Yazar","year":"2017","journal-title":"Turk. J. Surg"},{"key":"R38-17-20260114","first-page":"157","article-title":"Water-clear cell adenoma of the mediastinal parathyroid gland","volume":"35","author":"Arik","year":"2019","journal-title":"Turk. Patoloji Derg"},{"key":"R39-17-20260114","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1186\/s13256-016-1078-1","article-title":"Acute presentation of a giant intrathyroidal parathyroid adenoma: a case report","volume":"10","author":"Rutledge","year":"2016","journal-title":"J. Med. Case Rep"},{"key":"R40-17-20260114","doi-asserted-by":"crossref","first-page":"1957","DOI":"10.1097\/MLG.0b013e31813c14fc","article-title":"Correlation of intraoperative parathyroid hormone levels with parathyroid gland size","volume":"117","author":"Moretz","year":"2007","journal-title":"Laryngoscope"},{"key":"R41-17-20260114","first-page":"154","article-title":"Giant cystic parathyroid adenoma masquerading as a retropharangeal abscess","volume":"4","author":"Diom","year":"2014","journal-title":"Otolaryngology"},{"key":"R42-17-20260114","doi-asserted-by":"crossref","first-page":"197","DOI":"10.4103\/0973-1482.44292","article-title":"Airway obstruction due to giant non-parathyroid hormone producing parathyroid adenoma","volume":"4","author":"Kiverniti","year":"2008","journal-title":"J. Cancer Res. Ther"},{"key":"R43-17-20260114","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1016\/j.surg.2013.05.013","article-title":"Do giant parathyroid adenomas represent a distinct clinical entity?","volume":"154","author":"Spanheimer","year":"2013","journal-title":"Surgery"},{"key":"R44-17-20260114","doi-asserted-by":"crossref","first-page":"1334","DOI":"10.12659\/AJCR.911452","article-title":"A rare case of primary hyperparathyroidism caused by a Giant solitary parathyroid adenoma","volume":"18","author":"Mantzoros","year":"2018","journal-title":"Am. J. Case Rep"},{"key":"R45-17-20260114","first-page":"58","article-title":"Primary hyperparathyroidism","volume":"32","author":"Madkhali","year":"2016","journal-title":"Ulus Cerrahi Derg"},{"key":"R46-17-20260114","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1016\/j.surg.2007.07.023","article-title":"Consequences of parathyroidectomy in patients with \"mild\" sporadic primary hyperparathyroidism","volume":"142","author":"Carneiro-Pla","year":"2007","journal-title":"Surgery"},{"key":"R47-17-20260114","doi-asserted-by":"crossref","first-page":"1706","DOI":"10.2214\/AJR.06.0938","article-title":"Parathyroid imaging: technique and role in the preoperative evaluation of primary hyperparathyroidism","volume":"188","author":"Johnson","year":"2007","journal-title":"AJR Am. J. Roentgenol"},{"key":"R48-17-20260114","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1016\/j.surg.2003.06.001","article-title":"Comparison of intraoperative iPTH assay (QPTH) criteria in guiding parathyroidectomy: which criterion is the most accurate?","volume":"134","author":"Carneiro","year":"2003","journal-title":"Surgery"},{"key":"R49-17-20260114","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.ijsu.2015.11.045","article-title":"Retrospective evaluation of the pre- and postoperative factors influencing the sensitivity of localization studies in primary hyperparathyroidism","volume":"25","author":"Medas","year":"2016","journal-title":"Int. J. Surg"},{"key":"R50-17-20260114","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1053\/j.semnuclmed.2005.06.001","article-title":"Radionuclide imaging of the parathyroid glands","volume":"35","author":"Palestro","year":"2005","journal-title":"Semin. Nucl. Med"},{"key":"R51-17-20260114","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1097\/01.sla.0000179622.37270.36","article-title":"A comprehensive evaluation of perioperative adjuncts during minimally invasive parathyroidectomy: which is most reliable?","volume":"242","author":"Chen","year":"2005","journal-title":"Ann. Surg"},{"key":"R52-17-20260114","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1007\/s00268-004-7639-2","article-title":"Technetium-99m 2-methoxyisobutyl isonitrile-scintigraphy: preoperative and intraoperative guidance for primary hyperparathyroidism","volume":"28","author":"Farley","year":"2004","journal-title":"World J. Surg"},{"key":"R53-17-20260114","doi-asserted-by":"crossref","first-page":"2359","DOI":"10.1007\/s00268-016-3514-1","article-title":"Outcomes of parathyroidectomy in patients with primary hyperparathyroidism: a systematic review and meta-analysis","volume":"40","author":"Ospina","year":"2016","journal-title":"World J. Surg"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261221007975?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261221007975?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2021.106295","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T13:27:15Z","timestamp":1768397235000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2021.106295"}},"subtitle":["Case report and literature review"],"short-title":[],"issued":{"date-parts":[[2021,1]]},"references-count":53,"journal-issue":{"issue":"C","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2021.106295","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2021,1]]}}}