Abstract
Case Presentation: A 71-year-old woman with a history of papillary thyroid cancer underwent an uneventful total thyroidectomy 18 years ago. During the surgery, she had 2 parathyroid glands autotransplanted into the left infrahyoid (strap) muscle. She has since been cancer-free. She later presented with symptoms of fatigue, poor concentration, and abdominal pain for 3 months. She was also diagnosed with osteoporosis a year earlier. Biochemical analysis revealed findings consistent with primary hyperparathyroidism with intact parathyroid hormone of 90 pg/mL (normal, 18 to 88 pg/mL), calcium of 10.4 mg/dL (normal, 8.5 to 10.1 mg/dL) and ionized calcium of 6.1 mg/dL (normal, 4.5 to 5.6 mg/dL). Computed tomography scan of the neck demonstrated a hyperenhancing lesion within the left infrahyoid muscle (Fig. 1A). This correlated with a parathyroid sestamibi scan that revealed increased radiotracer activity within the lesion (Fig. 1B). What is the diagnosis?
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