Incidentally discovered parathyroid lipoadenoma in thyroid surgery: a case report and review of the literature

Background: Parathyroid lipoadenoma is a rare type of parathyroid adenoma, described as a single parathyroid adenoma with more than 50% fat on histologic examination and an unknown etiology, which is one of the rare causes of primary hyperparathyroidism. The difficulty of parathyroid lipoma is mainly diagnosed by preoperative imaging localization. We hope to arouse attention to the parathyroid adenoma which is difficult to locate through our case report. Case Description: The patient was a middle-aged male with a body mass index (BMI) of 38.4 who admitted to our hospital with a 40-day history of an untreated thyroid nodule. We incidentally discovered parathyroid lipoadenoma in his thyroid surgery. His prognosis was good, and there were no signs of recurrence at his 12-month follow-up appointment. Conclusions: : We believe that parathyroid lipoadenoma needs to rely on paraffin pathology to make a final diagnosis.This case report serves as a reminder that patients with preoperative unprovoked primary hyperparathyroidism and negative imaging findings may have a parathyroid lipoadenoma. During intraoperative thyroidectomy or lymph node dissection, it is important to carefully examine the adipose tissue for the possibility of parathyroid lipoadenoma, as this can lead to postoperative hypoparathyroidism or even intractable hypocalcemia.