Parathyromatosis: a very rare cause of recurrent primary hyperparathyroidism – case report and review of the literature

Abstract

Parathyromatosis is a rare entity and usually appears as a consequence of the seeding on previous parathyroid surgery which was applied for the secondary hyperparathyroidism. A 63-year-old woman presented with a history of subtotal thyroidectomy 20 years ago and parathyroidectomy due to primary hyperparathyroidism (PHPT) four years ago. Imaging methods revealed multiple parathyromatosis foci on subcutaneous tissue of the neck. En-bloc resection was performed and pathological examination confirmed the diagnosis of parathyromatosis. After an uneventful 10 months, biochemical and radiological tests revealed recurrence on bilateral thyroid lodges. En-bloc resection was performed. The patient has remained well for 24 months after the second operation and has been followed-up with normal parathormone and serum calcium values. To the best of our knowledge, this report describes the twenty-first case of parathyromatosis in PHPT setting in the literature. It should be kept in mind that parathyromatosis may recur at different sites in the neck even in patients with PHPT.

Hypercalcemia during pregnancy: management and outcomes for mother and child

“…Hyperparathyroidism due to diffusely spread hyperthyroid nodules, parathyromatosis, post-parathyroidectomy, in the context of malignancy, MEN syndromes, or in chronic renal disease has been rarely described [15,16]. Literature data on parathyromatosis is limited to around 20 cases published so far with only one report on a woman diagnosed and treated during pregnancy [17,18]. FHH is a rare autosomal dominant disorder, with a prevalence of~1:78.000 though this might likely be higher, as many cases remain asymptomatic lifelong and no causal treatment is available [19][20][21].…”

Parathyromatosis as a cause of recurrence primary hyperparathyroidism: A case report

“…The main reasons include: the presence of an atypically located parathyroid gland and/or undiagnosed multiglandular disease [ 3 ]. Parathyromatosis is a rare cause of recurrent hyperparathyroidism [ 4 ]. Its morphological basis is multiple foci of hyperactive parathyroid tissue, which are scattered in the soft tissues of the neck and/or mediastinum [ 5 ].…”

“…Its morphological basis is multiple foci of hyperactive parathyroid tissue, which are scattered in the soft tissues of the neck and/or mediastinum [ 5 ]. The main cause of this pathology is secondary implantation into the surrounding tissues of the damaged parathyroid gland (rough manipulation of the gland tissue) during the primary operation [ 4 , 5 ]. Most often occurs in patients who have undergone surgery for familial primary or secondary "renal" hyperparathyroidism [ [4] , [5] , [6] ].…”

“…The main cause of this pathology is secondary implantation into the surrounding tissues of the damaged parathyroid gland (rough manipulation of the gland tissue) during the primary operation [ 4 , 5 ]. Most often occurs in patients who have undergone surgery for familial primary or secondary "renal" hyperparathyroidism [ [4] , [5] , [6] ]. Parathyromatosis is extremely rare in primary sporadic hyperparathyroidism [ 4 ].…”

“…Most often occurs in patients who have undergone surgery for familial primary or secondary "renal" hyperparathyroidism [ [4] , [5] , [6] ]. Parathyromatosis is extremely rare in primary sporadic hyperparathyroidism [ 4 ].…”