Hyperparathyroid Crisis Due to Asymmetric Parathyroid Hyperplasia with A Massive Ectopic Parathyroid Gland |
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| Institution: | 1. Department of Medicine, Division of Endocrinology, Metabolism, and Nutrition, Durham, North Carolina.;2. Department of Surgery, Duke University Medical Center, Duke University, Durham, North Carolina.;1. Departments of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea.;2. Departments of General Surgery, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea.;3. Departments of Pathology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea.;1. Division of Pediatric Endocrinology, University of Miami, Miami, Florida;2. Department of Radiology, Children’s Hospital and Medical Center of Akron, Akron, Ohio;3. Center for Diabetes and Endocrinology, Children’s Hospital and Medical Center of Akron, Akron, Ohio. |
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| Abstract: | ObjectiveTo report a rare case of primary hyperparathyroidism presenting with hyper-parathyroid crisis due to parathyroid hyperplasia with ectopic glands.MethodsWe present the initial clinical manifestations, laboratory results, radiologic and surgical findings, and management in a patient who had hyper-parathyroid crisis. The pertinent literature and management options are also reviewed.ResultsA 60-year-old female presented with hyper-parathyroid crisis requiring preoperative stabilization with rehydration, diuresis, bisphosphonate therapy, and ultimately hemodialysis. Parathyroidectomy revealed asymmetric 4-gland hyperplasia, with a massive ectopic parathyroid gland in the tracheoesophageal groove extending into the mediastinum. Her postoperative course was complicated by hungry bone syndrome and hypocalcemia.ConclusionThis case illustrates the rare occurrence of hyper-parathyroid crises due to asymmetric parathyroid hyperplasia with a massive ectopic parathyroid gland. (Endocr Pract. 2014;20:e180-e182) |
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