Background: The essence of PARATHYROID surgery is finding the diseased gland or glands. Even experienced surgeons have a small miss rate despite numerous paraclinical localizing tecniques. The surgeons information about location of glands is the most important factor in finding them. The goal of anatomical research is to determin the location of glands and help improve surgeons information. Methods and Cases: To find ectopic cases of PARATHYROID glands this descriptive study which took 1.5 years was done on 100 cadavers which had been dissected for legal purposes. Obtained samples were dissected by classical method, and 871 tissue samples which were considered as PARATHYROID tissue were sent for pathological evaluation. Results: Four hundred-eleven tissue samples were diagnosed as PARATHYROID tissue. Fortyseven (11.5%) were ectopic. Seventeen ectopic glands were found in the postrosuperior part of the thyroid gland, 15 mediastinum and thymus, 8 in the posterior part of the esophagus and pharynx, and 7 in thyroid tissue. Seventeen percent of ectopic cases were in upper glands and 30% of ectopic glands were in lower glands (P =0.002). Conclusion: Possibility of existence of ectopic cases of PARATHYROID glands in thyroid and mediastinum should be considered during thyroid surgery.

Primary hyperPARATHYROIDism is a quite frequent disorder; however, giant PARATHYROID adenoma is a rare entity. We described a 39-year old woman presenting with lower extremities bone pain within the recent 3 years. She had been receiving levothyroxin during the past 10 years due to hypothyroidism, meanwhile, she had a bulge right thyroid lobe. Laboratory examinations revealed she was euthyroid, however, scanning showed PARATHYROID adenoma. During surgery, an adenoma measured 2x3x6cm, weighted 22gr was resected. Giant PARATHYROID adenoma present with non-characteristic symptoms, thus, routine laboratory measurements including serum calcium and phosphorous should be proposed for suspected individuals.

Thyroid malignant neoplasms are the most prevalent cancer of the endocrine system, and their concurrence with PARATHYROID neoplasms is extremely rare. We report a 69-year-old woman presenting with hypercalcemia and thyroid nodule, which histologic examination revealed bilateral papillary thyroid carcinoma with different variants coincident with PARATHYROID adenoma. Awareness of concomitant PARATHYROID and thyroid diseases may help manage patients with hypercalcemia history. So, we recommended a preoperative calcium check in a patient with a thyroid nodule.

Because of superficial location and not being covered by boney structure, thyroid is the ideal organ for 2-dimensional gray scale ultrasonography. Availability of relatively low cost equipment and ever increasing number of endocrinologists with expertise in thyroid ultrasound has made it an integral part of thyroid practice in the office of endocrinologists. In particular, the current recommendation for fine needle biopsy of thyroid nodules is ultrasound guided biopsy. Follow up of thyroid nodules for change in size can also be better documented by ultrasound than palpation. Although cytology obtained by fine needle biopsy is the gold standard for detection of malignancy, yet ultrasound features of the nodules direct the clinician to select for biopsy the higher risk nodules in a multinodular gland. For detection of PARATHYROID adenoma isotopic PARATHYROID scan is preferable but ultrasound is occasionally is needed for confirmation, in particular for cases when PARATHYROID isotopic scan is ambiguous. The present article is an overview of ultrasonography of thyroid and PARATHYROID intended for endocrinologists.

Background: Localization of ectopic PARATHYROID glands is one of the most sophisticated challenges in endocrine surgery and there is considerable controversy regarding the suitable approach to localize ectopic PARATHYROID glands and indications for using different modalities. The failure of the first operation leads to pain, scar, and financial burden of the following operation.Case: The patient was a 39-year-old woman hospitalized with hematuria as the main complaint and noticing the presentation of hypercalcemia in the initial tests underwent more thorough examination. Ultrasonography and 99mTc sestamibi scan helped us to localize the ectopic PARATHYROID gland in an anterior mediastinum and treat the patient in a one stage operation.Conclusion: Paying careful attention to the symptoms and signs, considering all differential diagnoses, and using appropriate diagnostic methods can be helpful in the diagnosis of rare syndromes.

Background: PARATHYROID hormone (PTH) levels can make changes in serum biomarkers and affect progression symptoms of many diseases. One of these is Parkinson’s disease (PD) and according to previous studies, it seems that PARATHYROID gland function is effective in severity of symptoms of PD. This study aimed to explore the role of PTH in PD progression regarding the lack of researches in this field in the Middle East.Methods: This case-control study was carried out in Alzahra hospital in Isfahan, Iran.125 patients with PD, diagnosed by experienced neurologists and 112 healthy controls matched for age and gender with patient group were asked to participate during September to November 2011. At baseline, the severity of PD was evaluated with motor part of the Unified Parkinson’s Disease Rating Scale III (UPDRS III). The level of PTH, calcium, phosphorus, and 25-hydroxy vitamin D were measured.Findings: The mean±SD of PTH level was significantly lower in patients group (45.2±18.8 IU/l) compared to controls (70.8±28.5 IU/l) (P=0.0001); there are not any significant correlation between hormone level, elements and severity of PD. We observed that men had more risk of PD than women (Odds ratio=2.53, [CI: 1.27‑5.03], P: 0.0080).Conclusion: This study could not confirm the relationship between the level of PARATHYROID gland function, the level of serum PTH and severity of motor symptoms in PD. It could be explained by the lack of a sufficient number of Hypo and hypercalcemia, phosphatemia and Hypo-or hyperPARATHYROIDism in our samples.