[Cervical macroadenoma causing hyperparathyroidism: Report of one case]

Area of Science:

• Endocrinology
• Neurosurgery
• Oncology

Background:

• Primary hyperparathyroidism is a common endocrine disorder often caused by parathyroid adenomas.
• Severe hypercalcemia can lead to significant complications, including renal stones and bone disease.

Observation:

• A 59-year-old male presented with severe hypercalcemia (14.9 mg/dl), elevated parathyroid hormone (PTH) levels (844 pg/mL), and a symptomatic cervical nodule.
• Imaging revealed a left lower parathyroid mass and bilateral renal stones. Bone densitometry indicated osteopenia and osteoporosis.

Findings:

• Surgical removal of a 22.6g parathyroid adenoma normalized calcium levels.
• Postoperatively, the patient developed secondary hyperparathyroidism due to vitamin D deficiency and hungry bone syndrome, indicated by low 25-OH vitamin D and persistent PTH elevation.
• Cholecalciferol administration effectively lowered PTH levels, resolving the secondary hyperparathyroidism.

Implications:

• Parathyroidectomy is an effective treatment for symptomatic parathyroid adenomas causing severe hypercalcemia.
• Vitamin D deficiency and hungry bone syndrome are important considerations post-parathyroidectomy, requiring monitoring and supplementation.
• Prompt diagnosis and management of hyperparathyroidism are crucial to prevent long-term complications such as renal and bone disease.