[Management of primary hyperparathyroidism with rare localization of ectopic adenoma parathyroid gland]

Topical diagnosis can be severely complicated in patients with primary hyperparathyroidism (PHPT) due to the ectopic placement of parathyroid gland (PTG) formations. We report a clinical case of PHPT in an 84-year-old patient caused by ectopic PTG adenoma located behind the right internal jugular vein at the level of the right submandibular gland. The impossibility of surgery for a long time due to the absence of a topical diagnosis has necessitated conservative treatment was required to get the hypercalcemia under control. In view of the concomitant deficiency of vitamin D, an attempt was made to use therapy with saturating doses of cholecalciferol under dynamic monitoring of the indicators of phosphorus-calcium metabolism, which allowed to achieve a significant decrease in PTH levels while maintaining normocalcemia.