A case report of rare giant parathyroid adenoma
Parathyroid adenoma weighing more than 3.5 g are referred as Giant parathyroid adenoma (GPA). These mainly present with primary hyperparathyroidism but have severe clinical presentations like severe hypercalcemia and significantly higher PTH levels. These features are sometimes indistinguishable fro...
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| Format: | Article |
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Elsevier
2022-12-01
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| Series: | Journal of Clinical and Translational Endocrinology Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214624522000211 |
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| author | Jaspreet Singh Ankit Manglunia Jayshree Swain Swayamsiddha Mangaraj Jaya bhanu Kanwar Abhay Sahoo |
| author_facet | Jaspreet Singh Ankit Manglunia Jayshree Swain Swayamsiddha Mangaraj Jaya bhanu Kanwar Abhay Sahoo |
| author_sort | Jaspreet Singh |
| collection | DOAJ |
| description | Parathyroid adenoma weighing more than 3.5 g are referred as Giant parathyroid adenoma (GPA). These mainly present with primary hyperparathyroidism but have severe clinical presentations like severe hypercalcemia and significantly higher PTH levels. These features are sometimes indistinguishable from parathyroid carcinoma. We describe an interesting case and clinical course of a young woman with GPA. A 27 years old woman previously asymptomatic presented with pain in left leg along with difficulty in walking and was subsequently diagnosed to have fracture of neck of left femur and severe hypercalcemia. On evaluation, the patient was found to have PTH dependent hypercalcemia and severe osteoporosis. USG neck revealed well defined heterogenous hypoechoic lesion suggestive of parathyroid adenoma. Tc99 sestamibi scan showed tracer localization to inferior aspect of lower lobe of right thyroid gland. She underwent right inferior parathyroidectomy and a giant parathyroid adenoma (GPA) weighing 20 g was excised. Histology confirmed parathyroid adenoma with mainly chief type cells. The tumour excision resulted in significant decline in PTH levels. She developed severe hungry bone syndrome (HBS) in post operative period. She was treated aggressively for HBS with intravenous calcium gluconate, oral calcium supplements along with calcitriol. GPA present as distinct clinical entity with features different from both parathyroid adenoma and parathyroid carcinoma. We will highlight the distinguishing points of GPA from parathyroid adenoma and parathyroid carcinoma. |
| first_indexed | 2024-04-11T06:12:41Z |
| format | Article |
| id | doaj.art-1056b6b7ef834db585891a9d8c00ef07 |
| institution | Directory Open Access Journal |
| issn | 2214-6245 |
| language | English |
| last_indexed | 2024-04-11T06:12:41Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Clinical and Translational Endocrinology Case Reports |
| spelling | doaj.art-1056b6b7ef834db585891a9d8c00ef072022-12-22T04:41:09ZengElsevierJournal of Clinical and Translational Endocrinology Case Reports2214-62452022-12-0126100127A case report of rare giant parathyroid adenomaJaspreet Singh0Ankit Manglunia1Jayshree Swain2Swayamsiddha Mangaraj3Jaya bhanu Kanwar4Abhay Sahoo5Department of Endocrinology, IMS & SUM Hospital, Siksha O Anusnadhan (Deemed to be) University, Bhubaneswar, Odisha, IndiaDepartment of Endocrinology, IMS & SUM Hospital, Siksha O Anusnadhan (Deemed to be) University, Bhubaneswar, Odisha, IndiaCorresponding author.; Department of Endocrinology, IMS & SUM Hospital, Siksha O Anusnadhan (Deemed to be) University, Bhubaneswar, Odisha, IndiaDepartment of Endocrinology, IMS & SUM Hospital, Siksha O Anusnadhan (Deemed to be) University, Bhubaneswar, Odisha, IndiaDepartment of Endocrinology, IMS & SUM Hospital, Siksha O Anusnadhan (Deemed to be) University, Bhubaneswar, Odisha, IndiaDepartment of Endocrinology, IMS & SUM Hospital, Siksha O Anusnadhan (Deemed to be) University, Bhubaneswar, Odisha, IndiaParathyroid adenoma weighing more than 3.5 g are referred as Giant parathyroid adenoma (GPA). These mainly present with primary hyperparathyroidism but have severe clinical presentations like severe hypercalcemia and significantly higher PTH levels. These features are sometimes indistinguishable from parathyroid carcinoma. We describe an interesting case and clinical course of a young woman with GPA. A 27 years old woman previously asymptomatic presented with pain in left leg along with difficulty in walking and was subsequently diagnosed to have fracture of neck of left femur and severe hypercalcemia. On evaluation, the patient was found to have PTH dependent hypercalcemia and severe osteoporosis. USG neck revealed well defined heterogenous hypoechoic lesion suggestive of parathyroid adenoma. Tc99 sestamibi scan showed tracer localization to inferior aspect of lower lobe of right thyroid gland. She underwent right inferior parathyroidectomy and a giant parathyroid adenoma (GPA) weighing 20 g was excised. Histology confirmed parathyroid adenoma with mainly chief type cells. The tumour excision resulted in significant decline in PTH levels. She developed severe hungry bone syndrome (HBS) in post operative period. She was treated aggressively for HBS with intravenous calcium gluconate, oral calcium supplements along with calcitriol. GPA present as distinct clinical entity with features different from both parathyroid adenoma and parathyroid carcinoma. We will highlight the distinguishing points of GPA from parathyroid adenoma and parathyroid carcinoma.http://www.sciencedirect.com/science/article/pii/S2214624522000211Giant parathyroid adenomaGPAParathyroid carcinomaHungry bone syndromeHBSPTH |
| spellingShingle | Jaspreet Singh Ankit Manglunia Jayshree Swain Swayamsiddha Mangaraj Jaya bhanu Kanwar Abhay Sahoo A case report of rare giant parathyroid adenoma Journal of Clinical and Translational Endocrinology Case Reports Giant parathyroid adenoma GPA Parathyroid carcinoma Hungry bone syndrome HBS PTH |
| title | A case report of rare giant parathyroid adenoma |
| title_full | A case report of rare giant parathyroid adenoma |
| title_fullStr | A case report of rare giant parathyroid adenoma |
| title_full_unstemmed | A case report of rare giant parathyroid adenoma |
| title_short | A case report of rare giant parathyroid adenoma |
| title_sort | case report of rare giant parathyroid adenoma |
| topic | Giant parathyroid adenoma GPA Parathyroid carcinoma Hungry bone syndrome HBS PTH |
| url | http://www.sciencedirect.com/science/article/pii/S2214624522000211 |
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