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

Al-Hassan, Mohamed S.; Mekhaimar, Menatalla; Ansari, Walid El; Darweesh, Adham; Abdelaal, Abdelrahman

doi:10.1186/s13256-019-2257-7

Cited by 37 publications

(40 citation statements)

References 30 publications

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“…3 Although the average size of a giant parathyroid adenoma is 5.65 grams, they rarely exceed 30 grams in weight with very few reports describing weights up to 110 grams. 3,4 Thus, our 37-gram adenoma is likely >99th percentile in size and weight. More interestingly, our giant adenoma was associated with a right ASA and NRLN and one of the presenting symptoms was severe headaches.…”

Section: Discussionmentioning

confidence: 91%

Giant Parathyroid Adenoma Associated With Aberrant Subclavian Artery and Nonrecurrent Laryngeal Nerve

Caceres

Parham

2021

Ear Nose Throat J

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Parathyroid adenomas are responsible for 80% to 85% of cases of primary hyperparathyroidism. Giant parathyroid adenomas are a rare type of parathyroid adenoma defined as weighing >3.5 grams. Although giant parathyroid adenomas are rare entities whose clinical presentation may not be atypical, their surgical management can be challenging, especially in the setting of anatomical variants. We present here a case of a 29-year-old female with a 37-gram giant adenoma which was diagnosed after presentation with recurrent severe headaches. The presentation was also unique in that it was associated with a right aberrant subclavian artery and nonrecurrent laryngeal nerve.

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Section: Discussionmentioning

confidence: 91%

Giant Parathyroid Adenoma Associated With Aberrant Subclavian Artery and Nonrecurrent Laryngeal Nerve

Caceres

Parham

2021

Ear Nose Throat J

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“…TE et al reported in his prospective database study a percentage of 10.7% from 519 patients for giant adenomas over eleven years despite using 3 g as their cutoff point for giant adenomas compared to our 3.5 g [ 13 ]. Also, five patients in our cohort presented with giant adenomas weighing over 10 g, the maximum was 32 g. These giant adenomas are unusual and were presented only as case reports in the literature [ 23 , 24 ]. These elevated numbers are more likely to be inflated as a result of the lack of routine calcium screening rather than PTAs displaying unique hyperproliferative patterns.…”

Section: Discussionmentioning

confidence: 93%

Giant versus regular parathyroid adenoma: A retrospective comparative study

Al-Gargaz

Abushukair

Odat

et al. 2021

Annals of Medicine &Amp; Surgery

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Background A fraction of Parathyroid Adenoma (PTA) is considered giant if they weigh more than 3.5 g. There is no clear consensus whether this subgroup has a distinct clinical or biochemical presentation that could have implications on PTA localization and management. In this study, we investigate the difference between regular and giant PTA patients regarding their clinical and laboratory findings as well as their postoperative outcomes. Materials and methods Clinical and PTA-related data were retrospectively retrieved from all patients undergoing parathyroidectomy from 2010 to 2019 at our hospital. Results A total number of 84 PTA (Females 76.2%) patients were included, of which 24 (28.6%) qualified as a giant with a mean weight of 7.86 g and the rest were regular adenomas (71.4%) with a mean weight of 1.45 g. Giant adenomas were more likely to present at a younger age compared to regular adenoma patients, (44.4 vs 50.8, P = 0.053, D = 0.470). Preoperative PTH levels were significantly higher in the giant PTA group (650.8 vs 334.2 pg/mL, P = 0.044, r = 0.22). Hospital stay was on average 1.6 days longer in giant PTA patients compared to regular PTA patients. Conclusion Giant PTA compromised a significant percentage of all adenomas, which was higher than what is reported in the literature and might reflect a delay in diagnosis and lack of screening tests. Both giant and regular adenomas seem to run a similar clinical course, yet biochemical abnormalities in PTH levels may have a predictive value for adenoma weight.

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“…Clinical presentation of giant parathyroid adenoma is mostly similar to parathyroid adenoma. However, while parathyroid adenomas (PAs) is usually asymptomatic, GPA is mostly symptomatic (4,5). The classic constellation of symptoms is rarely seen these days due to frequent routine chemical assessment and timely intervention.…”

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

Cited by 37 publications

References 30 publications

Giant Parathyroid Adenoma Associated With Aberrant Subclavian Artery and Nonrecurrent Laryngeal Nerve

Giant Parathyroid Adenoma Associated With Aberrant Subclavian Artery and Nonrecurrent Laryngeal Nerve

Giant versus regular parathyroid adenoma: A retrospective comparative study

Postoperative Hypocalcemia Following Parathyroidectomy for Giant Parathyroid Adenoma

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