PTH washout as a decisive biochemical tool in a diagnostic dilemma: Ectopic parathyroid adenoma mimicking metastatic disease
By: Ilker Çordan and Mustafa Çaycı
References
- Bilezikian JP, Khan AA, Silverberg SJ, Fuleihan GE, Marcocci C, Minisola S, et al. Evaluation and management of primary hyperparathyroidism: summary statement and guidelines from the Fifth International Workshop. J Bone Miner Res. 2022 Nov;37(11):2293-2314. DOI:10.1002/jbmr.4677
- Zhu R, Yue N, Hong Y, Ye Q, Han Z, Luo Z, et al. Ectopic parathyroid adenomas in primary hyperparathyroidism: anatomical classifications, localization strategies, and case series. Int J Surg. 2026;112(4):9958-9974. DOI:10.1097/JS9.0000000000004578
- Çordan İ, Aksu O. Lesion size and cystic morphology are key determinants of parathyroid hormone washout in primary hyperparathyroidism. Front Endocrinol (Lausanne). 2025;16:1654110. DOI:10.3389/fendo.2025.1654110
- Gökçay Canpolat A, Şahin M, Ediboğlu E, Erdoğan MF, Güllü S, Demir Ö, et al. Diagnostic accuracy of parathyroid hormone levels in washout samples of suspicious parathyroid adenomas: a single-centre retrospective cohort study. Clin Endocrinol (Oxf). 2018 Oct;89(4):489-495. DOI:10.1111/cen.13812
- Phitayakorn R, McHenry CR. Incidence and location of ectopic abnormal parathyroid glands. Am J Surg. 2006 Mar;191(3):418-423. DOI:10.1016/j.amjsurg.2005.10.049
- Hargitai L, Schefner M, Traub-Weidinger T, Haug A, Arikan M, Scheuba C, et al. Assessing the influence of 99mTc-sesta-MIBI-positive thyroid nodules on preoperative localisation studies in patients with primary hyperparathyroidism. Langenbecks Arch Surg. 2022 Apr;407(3):1183-1191. DOI:10.1007/s00423-022-02442-7
- Agarwal AM, Bentz JS, Hungerford R, Abraham D. Parathyroid fine-needle aspiration cytology in the evaluation of parathyroid adenoma: cytologic findings from 53 patients. Diagn Cytopathol. 2009 Jun;37(6):407-410. DOI:10.1002/dc.21020
- Cansu GB, Taşkıran B, Dizen H, Peker Cengiz B. Parathyroid hormone in washout fluid seems to be superior to cytology for localization of the lesion in MIBI-negative patients with primary hyperparathyroidism. Turk J Med Sci. 2017;47(6):1703-1707. DOI:10.3906/sag-1612-124
- Ha HJ, Kim EJ, Kim JS, Shin MS, Noh I, Park S, et al. Major clues and pitfalls in the differential diagnosis of parathyroid and thyroid lesions using fine needle aspiration cytology. Medicina (Kaunas). 2020 Oct 27;56(11):558. DOI:10.3390/medicina56110558
- Trimboli P, D’Aurizio F, Tozzoli R, Giovanella L. Measurement of thyroglobulin, calcitonin, and PTH in FNA washout fluids. Clin Chem Lab Med. 2017 Jul 1;55(7):914-925. DOI:10.1515/cclm-2016-0543
- Obołończyk Ł, Karwacka I, Wiśniewski P, Sworczak K, Osęka T. The current role of parathyroid fine-needle biopsy (P-FNAB) with iPTH-washout concentration (iPTH-WC) in primary hyperparathyroidism: a single center experience and literature review. Biomedicines. 2022 Jan 6;10(1):123. DOI:10.3390/biomedicines10010123
- Balbaloglu H, Deniz O, Ozaydin RY, Tasdoven I, Karadeniz Cakmak G. Parathyroid fine needle aspiration with PTH washout: can it lead to parathyroid cell seeding in primary hyperparathyroidism? Medicine (Baltimore). 2024 Apr 12;103(15):e37754. DOI:10.1097/MD.0000000000037754
- Norman J, Politz D, Browarsky I. Diagnostic aspiration of parathyroid adenomas causes severe fibrosis complicating surgery and final histologic diagnosis. Thyroid. 2007 Dec;17(12):1251-1255. DOI:10.1089/thy.2007.0081
- Ahmad S, Lilla E, Miller DV, Austin K, Hazel M, Ansari I, et al. Ultrasound-guided fine-needle aspiration biopsy of parathyroid adenomas in patients undergoing parathyroidectomy does not lead to clinically significant fibrosis. Gland Surg. 2025 Jun;14(6):974-982. DOI:10.21037/gs-2025-26
Language: English
Page range: 205 - 208
Submitted on: May 20, 2026
Accepted on: Jun 22, 2026
Published on: Jul 11, 2026
Published by: Romanian Association of Laboratory Medicine
In partnership with: Paradigm Publishing Services
Related subjects:
© 2026 Ilker Çordan, Mustafa Çaycı, published by Romanian Association of Laboratory Medicine
This work is licensed under the Creative Commons Attribution 4.0 License.