Background: The pyriform sinus is a potential location for ectopic parathyroid tissue and we describe the use of trans-oral robotic to excise the ectopic tissue.
Methods: A 55-year-old female presented with primary hyperparathyroidism. 4D computed tomography and Sestimibi scan revealed a 1.2 × 0.7 cm mass in the left pyriform sinus. Using the da Vinci SI robot, a 1 cm hypopharyngeal incision was made with electrocautery in the left pyriform sinus and used to excise the mass.
Results: Ectopic mass was removed via trans-oral robotic approach and final pathology confirmed parathyroid tissue. Parathyroid hormone level dropped from 135.8 to 13.3 pg/ml 15 min after excision of the mass.
Conclusion: Ectopic parathyroid tissue can present in many different areas of the neck, with the pyriform sinus being a potential location. The trans-oral robotic parathyroidectomy confers the advantage of the lack of an external incision for removal of ectopic parathyroid adenoma.
Keywords: Ectopic parathyroid; Parathyroid adenoma; Parathyroidectomy; Primary hyperparathyroidism; Trans-oral robotic surgery.