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. 2023 Jun 28;85(8):4075-4078.
doi: 10.1097/MS9.0000000000001005. eCollection 2023 Aug.

Giant parathyroid adenoma causing severe hypercalcemia; a case report from Duhok

Dildar Haji Musa  1 , Azri Salih Haji Sgery  1 , Asaad Shareef Omar  1 , Gina James Keorges  2 , Nashwan Mr Ibrahim  1
Affiliations

Giant parathyroid adenoma causing severe hypercalcemia; a case report from Duhok

Dildar Haji Musa et al. Ann Med Surg (Lond). .

Abstract

Nephrolithiasis, a common urological disease, could indicate a more ominous pathology beyond the kidneys. Patients who present with renal stones must be investigated for serum calcium and subsequently parathyroid hormones, if indicated, as one of the clinical presentations of primary hyperparathyroidism is renal stones.

Case presentation: A 48-year-old married female with a past medical history significant for renal stones presented to the clinic chiefly complaining of muscle pain, joint pain, and fatigue. After thorough investigations, she was diagnosed with a case of primary hyperparathyroidism due to parathyroid adenoma and was managed surgically according to guidelines.

Clinical discussion: Hypercalcemia, serum calcium of greater than 2 standard deviations above the reference value, is commonly seen to be associated with parathyroid mass therefore, assessment of serum calcium is a necessary step toward the diagnosis of parathyroid adenoma in cases with recurrent renal stones.

Conclusion: Recurrent nephrolithiasis requires more thorough investigation for the possible underlying cause. Primary hyperparathyroidism due to parathyroid adenoma can present with recurrent renal stones and some vague symptoms.

Keywords: giant parathyroid adenoma (GPTA); hypercalcemia; hypocalcemia; nephrolithiasis; primary hyperparathyroidism; renal stones.

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Conflict of interest statement

Authors declare no conflict of interest.

Figures

Figure 1
Figure 1
MRI showing the lesion.
Figure 2
Figure 2
larger one is the parathyroid adenoma; smaller one is the left thyroid lobe.
Figure 3
Figure 3
Microscopic feature of parathyroid adenoma composed mainly of chief cells.
See this image and copyright information in PMC

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