A giant parathyroid adenoma that was successfully managed by lobectomy and en bloc resection: a case report.

BACKGROUND

Giant parathyroid adenoma is a rare presentation of parathyroid adenoma and can manifest only with neck mass or non-specific symptoms.

CASE PRESENTATION

In this report, a 43-year-old woman was referred to our clinic with polyuria two months ago and a neck mass with newly diagnosed stage hypertension. No additional clinical presentations were found. The laboratory study revealed hyperparathyroidism (Parathyroid hormone (PTH): 1124 pg/ml) and hypercalcemia (15.8 mg/dl).

DISCUSSION

Color Doppler sonography showed a 32 × 15 × 20 mm well-defined hypoechoic solid mass in the region of the thyroid. Following this finding, a parathyroid sestamibi scan was performed as a complementary imaging modality to confirm the diagnosis of parathyroid adenoma, suspected due to elevated levels of PTH and calcium, and to accurately localize the lesion for surgical planning. The scintigraphy confirmed the presence of a giant parathyroid adenoma.

CONCLUSION

The patient underwent unblock resection of the involved parathyroid and after recovery, she was discharged in good condition. Giant parathyroid adenoma is rare and in patients with nonspecific symptoms, physicians should consider giant parathyroid adenoma in their differential diagnosis process even without common clinical manifestations of hyperparathyroidism.