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Case Reports
. 2023 Mar 25;85(4):1150-1153.
doi: 10.1097/MS9.0000000000000381. eCollection 2023 Apr.

Successful surgical management of primary hyperparathyroidism during pregnancy: a rare case report

Asil Musleh  1 , Oadi N Shrateh  2 , Khaled Abbadi  1 , Malvina Asbah  1 , Abdellatif Khader  1   2
Affiliations
Case Reports

Successful surgical management of primary hyperparathyroidism during pregnancy: a rare case report

Asil Musleh et al. Ann Med Surg (Lond). .

Abstract

Primary hyperparathyroidism (PHPT) in pregnancy is a rare condition. Because of gestational physiologic changes, it is easily under-recognized; in some cases, patients may remain symptomless while maintaining high serum calcium levels, posing a risk to the health of both mother and fetus.

Case presentation: Our patient is a pregnant woman in her 30th week of gestation admitted to the hospital with typical features of acute pancreatitis. All possible causes of acute pancreatitis were ruled out. Further investigation, including neck ultrasound, revealed a hypoechoic, well-defined, heterogeneous, and vascularized lesion measuring 1.9×1.7 cm, seen posterior to the left thyroid lobe and mostly representing a parathyroid adenoma. The patient was diagnosed to have a PHPT as the etiologic factor and underwent a successful parathyroidectomy after the failure of medical treatment.

Discussion and conclusion: Pregnancy-related parathyroid disease is uncommon. Several changes in calcium-regulating hormones occur during pregnancy, making the diagnosis of PHPT noticeably challenging. Therefore, serum calcium levels must be closely monitored during pregnancy for optimization of maternal and fetal outcomes. For the same reason, the appropriate management of gestational PHPT is mandatory, either medically or surgically.

Keywords: case report; gestational PHPT; hypercalcemia; pancreatitis; pregnancy.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Figure 1
Figure 1
Neck ultrasound showing a hypoechoic, well-defined, heterogeneous, and vascularized lesion measuring 1.9×1.7 cm, seen posterior to the left thyroid lobe (arrow).
Figure 2
Figure 2
Intraoperative image showing resection of the parathyroid adenoma (arrow).
See this image and copyright information in PMC

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