Uncommon presentations of parathyroid adenoma

Abstract

Although most patients with PA present with asymptomatic hypercalcemia, this disease entity must be considered in patients with other unusual presentations including hemorrhagic neck masses and dysphonia. The importance of a broad differential diagnosis and thorough workup is emphasized.

Non-functioning parathyroid adenoma: a rare differential diagnosis for vocal-cord paralysis

“…5 Most cases of primary hyperparathyroidism are found to be PAs. 1 Therefore, a painless, non-functioning parathyroid mass raises the suspicion of a parathyroid carcinoma. 5 Furthermore, the presentation of gradual-onset VCP suggests malignant invasion of the RLN, which raises further the suspicion of a carcinoma.…”

“…2 Studies have reported VCP to be a rare presentation of a PA, but the patients in those studies had functioning PAs. [1][2][3][4] Primary hyperparathyroidism is seen in 20-30/100,000 people, and most cases are due to PAs. Hyperparathyroidism is Figure 2 Gross specimen of the resected parathyroid mass showing a multi-cystic, haemorrhagic appearance with ill-defined borders manifested by fatigue, bone pain, abdominal pain, weakness, dyspepsia, nephrolithiasis and skeletal bone disease.…”

“…1 Parathyroid adenomas (PAs) presenting as vocal-cord paralysis (VCP) are rare. 1 Patients with functioning PAs have been reported to have elevated levels of calcium and parathyroid hormone (PTH).…”

“…1 Parathyroid adenomas (PAs) presenting as vocal-cord paralysis (VCP) are rare. 1 Patients with functioning PAs have been reported to have elevated levels of calcium and parathyroid hormone (PTH). [1][2][3][4] In context of parathyroid disease, patients who present with VCP and have normal laboratory investigations carry a high suspicion of a malignant parathyroid carcinoma that has invaded the recurrent laryngeal nerve (RLN).…”

“…1 Patients with functioning PAs have been reported to have elevated levels of calcium and parathyroid hormone (PTH). [1][2][3][4] In context of parathyroid disease, patients who present with VCP and have normal laboratory investigations carry a high suspicion of a malignant parathyroid carcinoma that has invaded the recurrent laryngeal nerve (RLN). 2 Here, we describe, for the first time, a case of a non-functioning benign tumour of the parathyroid gland presenting as VCP.…”