Two Cases of Hungry Bone Syndrome after Huge Parathyroidectomy

Hyeongjoo Lee; Jinpyeong Kim; Jungje Park; Seunghoon Woo

doi:10.11106/cet.2015.8.1.108

Journal List > J Korean Thyroid Assoc > v.8(1) > 1056579

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Lee, Kim, Park, and Woo: Two Cases of Hungry Bone Syndrome after Huge Parathyroidectomy

Original Article

Clin Exp Thyroidol 2015;8(1):108-112.

Published online: 4 May 2015

DOI: https://doi.org/10.11106/cet.2015.8.1.108

Two Cases of Hungry Bone Syndrome after Huge Parathyroidectomy

Hyeongjoo Lee¹, Jinpyeong Kim¹, Jungje Park¹, Seunghoon Woo^1,²

Department of Otolaryngology, Gyeongsang National University, Jinju, Korea

Institute of Health Sciences, Gyeongsang National University, Jinju, Korea

Correspondence: Seunghoon Woo, MD, Department of Otorhinolaryngology, Gyeongsang National University, 90 Chilam-dong, Jinju 660-702, Korea Tel: 82-55-750-8173, Fax: 82-55-759-0613, E-mail: lesaby@hanmail.net

Received 10 August 2014 Accepted 1 December 2014

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Hungry bone syndrome can occur after parathyroidectomy which is performed due to primary hyperparathyroidism. Hungry bone syndrome is characterized by showing postoperative hypocalcemia which is caused by the remineralization of various minerals, including calcium inside the bone. This syndrome requires a long term supplementation of calcium. Identifying the preoperative predictors of hypocalcemia is essential and important for postoperative management. From here on in, we report two cases of patients with parathyroid adenoma who have undergone parathyroidectomy. We would like to report and discuss the management of hungry bone syndrome experienced from the two cases that have been mentioned above. We report these two cases with a review of the literature.

Keywords: Parathyroidectomy, Hypocalcemia, Parathyroid hormone

References

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Fig. 1.

Neck ultrasonography of a parathyroid tumor which is 4.23×2.78×4.99 cm in size and well defined. And this tumor is also a homogeneous and hypoechoic mass which is round in shape.

Fig. 2.

Computed tomographic images of parathyroid tumor. Left. thyroid lobe was displaced anteriorly by a irregularly defined heterogeneous enhanced mass which was finally reported as being an atypia of unknown significant of thyroid.

Fig. 3.

Thallium scan (Tc-99m sestamibi parathyroid scintigraphy) shows increased focal uptake at the area of the Left. lobe of the thyroid gland in both images.

Fig. 4.

A pathologic finding of a parathyroid adenoma with a stromal rim of a normal parathyroid tissue (arrow).

Fig. 5.

Graph showing changes in serum PTH, Ca after the operation.

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