Rare Giant parathyroid adenoma reported in Indian woman

Dr Mohamed S. Al-Hassan at the Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar and colleagues have reported a rare case of Giant parathyroid adenoma. The case has appeared in the Journal of Medical Case Reports.

The normal parathyroid gland weighs approximately 50–70 mg. Giant 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. 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.

A 52-year-old Indian woman was referred to our Surgical Endocrinology clinic at Hamad General Hospital in Doha, Qatar. She complained of neck swelling and generalized fatigue. Laboratory results showed hypercalcemia and elevated PTH. Her past social, environmental, family, and employment history (housewife) were unremarkable. She did not smoke tobacco and never consumed alcohol. There was no past history of symptomatic kidney stones; however, a recent computed tomography (CT) scan of her abdomen and pelvis showed a 2 mm non-obstructing calculus in the lower pole calyx of her right kidney with no hydroureteronephrosis. Her past medical history indicated that she had dyslipidemia, controlled with medication; however, she was not on any other medication. On physical examination, a right-sided neck swelling was obvious on inspection; on palpation, a mobile non-tender nodule could be felt, approximately 3 cm in size. The rest of the physical examination was unremarkable. A neurological examination was unremarkable. On admission, her pulse, blood pressure and temperature were normal.

Ultrasound showed a complex nodule with solid and cystic components, and a Sestamibi nuclear scan confirmed a GPTA. Focused surgical neck exploration was done and a GPTA weighing 7.7 gm was excised. This case of non-ectopic GPTA is unusual in that it presented mainly with a visible palpable right-sided neck mass, which was large to the extent that the initial ultrasound suggested that it could be a thyroid nodule.

Focused surgical neck exploration was done and a giant parathyroid adenoma weighing 7.7 gm was excised.

For further reference log on to :https://doi.org/10.1186/s13256-019-2257-7

Journal of Medical Case Reports