A Parathyroid Adenoma : Benign Disease Presenting with Hyperparathyroid Crisis

Abstract EN

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 (CCa2+) 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 CCa2+ 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.