Giant intrathyroidal parathyroid adenoma

Vilallonga, Ramón; Zafón, Carlos; Migone, Raul; Baena, J. D.

doi:10.4103/0974-2700.96497

Cited by 9 publications

(6 citation statements)

References 13 publications

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“… 5 Many patients are symptomatic in the early stage, and the disease process is detected on routine investigations. 6 PHPT can be caused by parathyroid hyperplasia, single or multiple adenomas, carcinoma, or an ectopic parathyroid gland. Some familial causes of PHPT include multiple endocrine neoplasia type 1 or 2A, familial benign hypocalciuric hypercalcemia, and hyperparathyroidism-jaw tumour syndrome.…”

Section: Discussionmentioning

confidence: 99%

Primary hyperparathyroidism caused by an ectopic parathyroid adenoma in an uncommon location: a case report

Khalaf

Sarwani

George

et al. 2021

Journal of Taibah University Medical Sciences

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Primary hyperparathyroidism caused by an ectopic parathyroid adenoma in the mediastinum is a rare clinical condition. We present a 75-year-old male with primary hyperparathyroidism caused by an ectopic parathyroid adenoma in the mediastinum. This patient was initially referred to the clinic for suspected incidental hypercalcemia. Initial imaging showed two suspicious lesions: one adjacent to the thyroid gland and another in the mediastinum. Further investigations identified a sole mediastinal adenoma. The diagnosis was confirmed by normalization of parathyroid hormone levels after its surgical resection. Thoroughly diagnosing such cases can prove challenging and using a single modality such as ultrasonography, computed tomography, or nuclear imaging alone may not yield conclusive findings or can give false positive results. Our case demonstrates that a combination of several imaging modalities can lead to accurate localization of the cause of primary hyperparathyroidism. This will obviate the performance of unnecessary surgical procedures. In addition, the possibility of missing additional sources of ectopic secretions of the parathyroid hormone will be reduced.

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Section: Discussionmentioning

confidence: 99%

Primary hyperparathyroidism caused by an ectopic parathyroid adenoma in an uncommon location: a case report

Khalaf

Sarwani

George

et al. 2021

Journal of Taibah University Medical Sciences

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“…However, our patient did not have a routine health check-up for a prolonged period and presented with symptoms suggestive of chronic hypercalcemia. Rarely, patients can present with severe conditions such as hyperparathyroidism crisis and acute pancreatitis (6,7). GPAs slowly grow over the years; however, occasionally, they can have rapid enlargement due to cystic changes (8).…”

Section: Discussionmentioning

confidence: 99%

Postoperative Hypocalcemia Following Parathyroidectomy for Giant Parathyroid Adenoma

Raj

Amine

Herodotou

2020

AACE Clinical Case Reports

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Objective: Giant parathyroid adenomas (GPAs) are a rare type of parathyroid adenoma (PA) weighing >2 to 3 g. The objective of this manuscript is to report a case of giant parathyroid adenoma and highlight the risk of postoperative hypocalcemia. Methods: We describe the presentation and work-up of a woman with GPA confirmed with histopathology as well as management of postoperative hypocalcemia. Results: A 66-year-old Caucasian female with chronic fatigue was found to have elevated calcium levels at 13.7 mg/dL (normal, 8.9 to 10.2 mg/dL) and elevated parathyroid hormone levels at 1,240 pg/mL (normal, 12 to 72 pg/mL). Contrast enhanced computed tomography scan of the neck showed a 5.6 cm heterogeneous mass posterior to the right thyroid. The patient underwent right parathyroidectomy and histopathology confirmed the diagnosis of a giant parathyroid adenoma (GPA) weighing 28.7 g. Postoperatively, the patient developed hypocalcemia secondary to hungry bone syndrome and was treated aggressively with intravenous calcium supplementation. At 4 weeks postoperatively, she had normal calcium levels without any calcium supplementation. Conclusion: GPAs are a rare variant of PA, and could be a distinct clinical entity with features different from both PA and parathyroid carcinoma. We further postulate that the risk of postoperative hypocalcemia secondary to hungry bone syndrome could be higher among patients with GPA compared to patients with PA. These hypotheses needs to be validated with further studies.

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“…However, this full constellation of symptoms is rarely seen nowadays due to the more frequent routine assessments of blood chemistries of patients presenting to hospital and clinics. Hence, such early detection has led to the majority of patients with PHPT now being identified early in the asymptomatic stage [4, 10]. However, our review of cases of GPTA published during the last 10 years (Table 1, 20 case reports, 22 patients with GPTA) shows that only two out of the 22 published cases were completely free of signs and symptoms of hypercalcemia [15, 17].…”

Section: Discussionmentioning

confidence: 99%

“…On the contrary, Table 1 suggests that most GPTAs presented symptomatically, ranging from vague bone/abdominal pain [5, 11, 18, 24] to more severe presentations, for example chronic depression, recurrent symptomatic kidney stones, and severe gastrointestinal symptoms [1, 9, 13, 14, 19–22]. Very rare presentations included hyperparathyroid crisis and acute pancreatitis [1, 10, 16]. Our current patient presented with neck swelling and generalized fatigue, and she had a silent kidney stone that was identified by abdominal CT, suggesting that GPTA generally presents symptomatically or with signs of hypercalcemia.…”

Section: Discussionmentioning

confidence: 99%

Giant parathyroid adenoma: a case report and review of the literature

et al. 2019

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BackgroundGiant parathyroid adenoma is a rare type of parathyroid adenoma defined as weighing > 3.5 g. They present as primary hyperparathyroidism but with more elevated laboratory findings and more severe clinical presentations due to the larger tissue mass. This is the first reported case of giant parathyroid adenoma from the Middle East.Case presentationA 52-year-old Indian woman presented with a palpable right-sided neck mass and generalized fatigue. Investigations revealed hypercalcemia with elevated parathyroid hormone and an asymptomatic kidney stone. Ultrasound showed a complex nodule with solid and cystic components, and Sestamibi nuclear scan confirmed a giant parathyroid adenoma. Focused surgical neck exploration was done and a giant parathyroid adenoma weighing 7.7 gm was excised.ConclusionsGiant parathyroid adenoma is a rare cause of primary hyperparathyroidism and usually presents symptomatically with high calcium and parathyroid hormone levels. Giant parathyroid adenoma is diagnosed by imaging and laboratory studies. Management is typically surgical, aiming at complete resection. Patients usually recover with no long-term complications or recurrence.

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Giant intrathyroidal parathyroid adenoma

Cited by 9 publications

References 13 publications

Primary hyperparathyroidism caused by an ectopic parathyroid adenoma in an uncommon location: a case report

Primary hyperparathyroidism caused by an ectopic parathyroid adenoma in an uncommon location: a case report

Postoperative Hypocalcemia Following Parathyroidectomy for Giant Parathyroid Adenoma

Giant parathyroid adenoma: a case report and review of the literature

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