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The Parathyroid Glands00:59

The Parathyroid Glands

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The two pairs of parathyroid glands embedded within the posterior surface of the thyroid gland are restricted by a dense capsule around them. These glands comprise two distinct cell populations—parathyroid oxyphil and parathyroid principal cells- pivotal in calcium homeostasis.
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by...
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Giant Parathyroid Adenoma: A Case Report.

Siddharth Shah1, Priscilla Fujikawa1, Kenneth Brand1

  • 1Internal Medicine, Lewis Gale Medical Center, Salem, USA.

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Summary

A rare giant parathyroid adenoma caused severe hypercalcemia and debilitating symptoms. Treatment involved managing extreme calcium levels and addressing hungry bone syndrome post-surgery.

Keywords:
giant parathyroid adenomahungry bone syndromeparathyroid and lipid disordersparathyroid function testparathyroid gland adenomaparathyroid hormone (pth)postoperative parathyroid hormone (pth)

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Area of Science:

  • Endocrinology
  • Oncology

Background:

  • Parathyroid adenomas are typically small, rarely exceeding 4 grams.
  • Giant parathyroid adenomas are exceptionally rare and can lead to severe clinical manifestations.

Observation:

  • A patient presented with a 5.3-gram parathyroid adenoma causing significant hypercalcemia (calcium > 17 mg/dl).
  • Symptoms included bilateral knee pain, limited mobility, constipation, low back pain, and frontal headache.

Findings:

  • Initial management involved hemodialysis, calcitonin, Zoledronate, and IV hydration to lower calcium levels pre-parathyroidectomy.
  • Post-parathyroidectomy, the patient developed hungry bone syndrome, successfully treated with calcium carbonate and calcitriol.

Implications:

  • This case highlights the challenges in managing extreme hypercalcemia from a giant parathyroid adenoma.
  • It underscores the importance of recognizing and treating hungry bone syndrome after parathyroidectomy for severe hyperparathyroidism.