Parathyroid hyperplasia of auto-transplanted tissue in forearm skin

Currently, the treatment of choice for refractory tertiary hyperparathyroidism is a total parathyroidectomy with autotransplantation of the parathyroid tissue into the forearm. Recurrent hyperparathyroidism after autotransplantation requiring surgical excision of the autograft is uncommon. We describe a female patient with recurrent hyperplasia who underwent an excision of her parathyroid autograft. The excisional specimen was submitted to pathology with the only provided history of a 'left arm mass'. The lack of clinical history led to a preliminary impression of an adnexal neoplasm by the primary pathologist.