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A parathyroid adenoma: benign disease presenting with hyperparathyroid crisis - PubMed

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Case Reports

A parathyroid adenoma: benign disease presenting with hyperparathyroid crisis

A S Tahim et al. Case Rep Med. 2010.

Abstract

Hyperparathyroid crisis is a rare manifestation of parathyroid disease. We present the case of a 53-year-old gentleman with a review of the current literature. He presented in acute renal failure with epigastric pain and vomiting. His serum-corrected calcium (CCa(2+)) was raised at 5.2 mmol/L, in addition to a massively raised parathyroid hormone (PTH) level (3957 ng/L). Ultrasound studies of the neck revealed a 2 cm well-defined mass inferoposterior to right thyroid lobe. CT scans of the neck showed a normal mediastinum and confirmed no associated lymphadenopathy. Having undergone medical resuscitation for 9 days, a neck exploration revealed a cystic mass, which was excised. Histological investigations revealed a 9.25 g, cystic parathyroid adenoma with no features of malignancy. His PTH and CCa(2+) returned to normal postoperatively. This suspicious presentation of benign disease, including a marked elevation in PTH, highlights the challenges facing the endocrine surgeon in dealing with parathyroid disease.

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Figures

Figure 1
Figure 1

USS neck revealing 3.69 cm × 2.11 cm lesion in right side of neck.

Figure 2
Figure 2

CT neck showing large right sided neck lesion.

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