Question

I have been having difficulty swallowing, along with a soreness and tightness in my neck. I can also feel a lump in my neck. I had a thyroid ultrasound, which showed a possible thyroid nodule vs. parathyroid adenoma. Could I be feeling the parathyroid adenoma?


Answer
Deva Boone
Answer authored by Deva Boone
Deva Boone, MD is the founder of the Southwest Parathyroid Center. As one of the most experienced parathyroid surgeons in the U.S., she has treated thousands of patients with parathyroid conditions.

It is usually nearly impossible to feel parathyroid tumors. Even when large, they tend to be soft and squishy, and don’t cause pain. Sometimes, if you have a large and deep adenoma, you can feel something when swallowing, though this rarely causes actual difficulty swallowing.   What you are describing actually sounds more like thyroiditis, or an inflammatory condition of thyroid. The most common form is Hashimoto’s thyroiditis (which is actually fairly common, though you might not have heard the name). It can cause pain and tightness in the neck, where the thyroid is, and can give a feeling of difficulty swallowing when there is more inflammation. It tends to be a condition that waxes and wanes, so you won’t always feel the pain or tightness.    We do not diagnose parathyroid tumors on imaging studies. The only way to know if you have a parathyroid tumor is to check calcium and PTH. If these are normal, then the mass on ultrasound is a thyroid nodule. Nodules are common in cases of thyroiditis. 

Thyroid nodule Thyroiditis Diagnosis