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Case Report Open Access

Percutaneous ablation of intrathyroidal parathyroid adenoma: A case report and brief review of the literature

  • Authors:
    • Aras J. Qaradakhy
    • Abdulwahid M. Salih
    • Shaho F. Ahmed
    • Rebaz M. Ali
    • Ari M. Abdullah
    • Aso N. Qadir
    • Imad J. Habibullah
    • Hawkar A. Nasralla
    • Abdullah A. Qadir
    • Fahmi H. Kakamad
  • View Affiliations / Copyright

    Affiliations: Department of Scientific Affairs, Smart Health Tower, Sulaymaniyah 46001, Iraq
    Copyright: © Qaradakhy et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].
  • Article Number: 1
    |
    Published online on: November 11, 2025
       https://doi.org/10.3892/mi.2025.285
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Abstract

Primary hyperparathyroidism (HPT), predominantly caused by parathyroid adenomas (PAs), leads to elevated calcium levels and a range of complications, including renal, skeletal and cardiovascular issues. While parathyroidectomy is the standard treatment for resolving hypercalcemia, the present study describes a case of intrathyroidal PA treated with microwave ablation (MWA). A 29‑year‑old woman with recurrent HPT presented with elevated parathyroid hormone (183 pg/ml) and serum calcium (11.06 mg/dl) levels following a previous right upper and lower parathyroidectomy. Imaging revealed a well‑defined hypoechoic nodule within the right thyroid lobe, confirmed as an intrathyroidal PA following sestamibi scanning. The patient underwent MWA, achieving the rapid normalization of parathyroid hormone and calcium levels. Although PA is a common cause of primary HPT, a thorough review of the literature found no instances of intrathyroidal PA treated with MWA. On the whole, the present case report demonstrates that MWA may be a safe and effective alternative for the treatment of intrathyroidal PAs, particularly when traditional surgery is not a viable option.
View Figures

Figure 1

Ultrasound images illustrating a
small, well-defined, solid hypoechoic nodule measuring 10x7.7x4.8
mm with a regular surface and prominent hypervascularity, located
in the mid-third of the right thyroid lobe. The image on the left
panel (color Doppler mode) illustrates the nodule indicated by the
white arrow, while the yellow boxed area marks the region of
interest used for Doppler evaluation, demonstrating multiple
intranodular color flow signals consistent with marked
hypervascularity. The image on the right panel (grayscale mode)
depicts the same hypoechoic nodule (white arrow) with smooth,
well-defined margins and homogeneous echotexture, without
calcification or cystic changes. These imaging characteristics are
compatible with an intrathyroidal parathyroid adenoma.

Figure 2

Sequential 99mTc-sestamibi
scintigraphy images obtained at different time intervals
demonstrating radiotracer uptake and washout patterns in the
thyroid region. (A) At 20 min (early phase), there is intense
radiotracer uptake in both thyroid lobes, with a focally increased
accumulation in the right thyroid lobe, suggesting a
hyperfunctioning lesion. (B) At 60 min, partial washout of tracer
activity is observed from most of the thyroid tissue, while the
right thyroid lobe shows persistent uptake. (C) At 120 min, further
washout from normal thyroid tissue occurs, with sustained focal
uptake in the right lobe. (D) At 180 min, complete washout from the
thyroid gland is seen, except for persistent radiotracer retention
in the mid-portion of the right lobe, confirming the presence of an
intrathyroidal parathyroid adenoma.

Figure 3

Ultrasound images of the right thyroid
lobe obtained immediately following microwave ablation,
illustrating post-procedural changes in the treated nodule. The
image on the left panel (color Doppler mode) illustrates the
ablated nodule indicated by the white arrow, demonstrating marked
reduction in internal vascularity compared with the pre-ablation
study. The boxed white area represents the region of interest used
for Doppler assessment, confirming diminished or absent blood flow
within the ablated zone. The image on the right panel (grayscale
mode) depicts the same nodule (white arrow) with inhomogeneous
echotexture and a hyperechoic halo corresponding to coagulative
necrosis, consistent with a successful ablation outcome.
View References

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Copy and paste a formatted citation
Spandidos Publications style
Qaradakhy AJ, Salih AM, Ahmed SF, Ali RM, Abdullah AM, Qadir AN, Habibullah IJ, Nasralla HA, Qadir AA, Kakamad FH, Kakamad FH, et al: Percutaneous ablation of intrathyroidal parathyroid adenoma: A case report and brief review of the literature. Med Int 6: 1, 2026.
APA
Qaradakhy, A.J., Salih, A.M., Ahmed, S.F., Ali, R.M., Abdullah, A.M., Qadir, A.N. ... Kakamad, F.H. (2026). Percutaneous ablation of intrathyroidal parathyroid adenoma: A case report and brief review of the literature. Medicine International, 6, 1. https://doi.org/10.3892/mi.2025.285
MLA
Qaradakhy, A. J., Salih, A. M., Ahmed, S. F., Ali, R. M., Abdullah, A. M., Qadir, A. N., Habibullah, I. J., Nasralla, H. A., Qadir, A. A., Kakamad, F. H."Percutaneous ablation of intrathyroidal parathyroid adenoma: A case report and brief review of the literature". Medicine International 6.1 (2026): 1.
Chicago
Qaradakhy, A. J., Salih, A. M., Ahmed, S. F., Ali, R. M., Abdullah, A. M., Qadir, A. N., Habibullah, I. J., Nasralla, H. A., Qadir, A. A., Kakamad, F. H."Percutaneous ablation of intrathyroidal parathyroid adenoma: A case report and brief review of the literature". Medicine International 6, no. 1 (2026): 1. https://doi.org/10.3892/mi.2025.285
Copy and paste a formatted citation
x
Spandidos Publications style
Qaradakhy AJ, Salih AM, Ahmed SF, Ali RM, Abdullah AM, Qadir AN, Habibullah IJ, Nasralla HA, Qadir AA, Kakamad FH, Kakamad FH, et al: Percutaneous ablation of intrathyroidal parathyroid adenoma: A case report and brief review of the literature. Med Int 6: 1, 2026.
APA
Qaradakhy, A.J., Salih, A.M., Ahmed, S.F., Ali, R.M., Abdullah, A.M., Qadir, A.N. ... Kakamad, F.H. (2026). Percutaneous ablation of intrathyroidal parathyroid adenoma: A case report and brief review of the literature. Medicine International, 6, 1. https://doi.org/10.3892/mi.2025.285
MLA
Qaradakhy, A. J., Salih, A. M., Ahmed, S. F., Ali, R. M., Abdullah, A. M., Qadir, A. N., Habibullah, I. J., Nasralla, H. A., Qadir, A. A., Kakamad, F. H."Percutaneous ablation of intrathyroidal parathyroid adenoma: A case report and brief review of the literature". Medicine International 6.1 (2026): 1.
Chicago
Qaradakhy, A. J., Salih, A. M., Ahmed, S. F., Ali, R. M., Abdullah, A. M., Qadir, A. N., Habibullah, I. J., Nasralla, H. A., Qadir, A. A., Kakamad, F. H."Percutaneous ablation of intrathyroidal parathyroid adenoma: A case report and brief review of the literature". Medicine International 6, no. 1 (2026): 1. https://doi.org/10.3892/mi.2025.285
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