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Review
. 2019 Nov 14;13(1):332.
doi: 10.1186/s13256-019-2257-7.

Giant parathyroid adenoma: a case report and review of the literature

Mohamed S Al-Hassan  1 , Menatalla Mekhaimar  2 , Walid El Ansari  3   4   5 , Adham Darweesh  6 , Abdelrahman Abdelaal  1
Affiliations
Review

Giant parathyroid adenoma: a case report and review of the literature

Mohamed S Al-Hassan et al. J Med Case Rep. .

Abstract

Background: 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. This is the first reported case of giant parathyroid adenoma from the Middle East.

Case presentation: A 52-year-old Indian woman presented with a palpable right-sided neck mass and generalized fatigue. Investigations revealed hypercalcemia with elevated parathyroid hormone and an asymptomatic kidney stone. Ultrasound showed a complex nodule with solid and cystic components, and Sestamibi nuclear scan confirmed a giant parathyroid adenoma. Focused surgical neck exploration was done and a giant parathyroid adenoma weighing 7.7 gm was excised.

Conclusions: Giant parathyroid adenoma is a rare cause of primary hyperparathyroidism and usually presents symptomatically with high calcium and parathyroid hormone levels. 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.

Keywords: Atypical parathyroid adenoma; Giant parathyroid adenoma; Minimal invasive parathyroidectomy; Parathyroidectomy; Primary hyperparathyroidism.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Ultrasound of the neck showing complex nodule of the right lobe with solid and cystic components (a) and vascularity (b)
Fig. 2
Fig. 2
Early and late 99mTc-sestamibi scintigraphy parathyroid scan images of neck and mediastinum anteriorly at 20 minutes and 2 hours showing increased focal uptake suggestive of right giant parathyroid adenoma
Fig. 3
Fig. 3
Giant parathyroid adenoma identified intraoperatively
Fig. 4
Fig. 4
Excised giant parathyroid adenoma (4 × 2.5 × 1.5 cm)
See this image and copyright information in PMC

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