Journal List > J Korean Soc Endocrinol > v.20(3) > 1063789

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Yoo, Kim, Park, Kim, Yang, Park, Kim, Seo, Lee, Kim, Choi, Lee, Lee, Baik, and Choi: A Case of Primary Hyperparathyroidism Caused by Cystic Parathyroid Adenoma, Diagnosed during Intra-Operative PTH Monitoring
Case Report
Journal of Korean Society of Endocrinology

Journal of Korean Society of Endocrinology 2005; 20(3): 278-282.

Published online: 30 June 2005

DOI: https://doi.org/10.3803/jkes.2005.20.3.278

A Case of Primary Hyperparathyroidism Caused by Cystic Parathyroid Adenoma, Diagnosed during Intra-Operative PTH Monitoring

Hye Jin Yoo, Nan Hee Kim, Soo Yeon Park, Dong Jin Kim, Sae Jeung Yang, Ju Ri Park, Hee Young Kim, Ji A Seo, Kye Won Lee, Sin Gon Kim, Kyung Mook Choi, Jae Bok Lee1, Young Seok Lee2, Sei Hyun Baik, Dong Seop Choi

Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea.

1Department of General Surgery, College of Medicine, Korea University, Seoul, Korea.

2Department of Pathology, College of Medicine, Korea University, Seoul, Korea.

Received 14 March 2005       Accepted 25 April 2005

Copyright © 2005 Korean Endocrine Society

Abstract

Primary hyperparathyroidism is the most frequent cause of hypercalcemia, and its prevalence is increasing due to the routine examination of serum calcium levels. Primary hyperparathyroidims is most commonly caused by an adenoma or hyperplasia of the parathyroid gland. A cystic parathyroid adenoma is an extremely rare cause of primary hyperparathyroidism.
In our case, a-79-year old female presented with lower back pain and constipation. Her serum calcium, phosphate and immunoreactive parathyroid homone levels were 15.6, 1.8 mg/dL and 371.8 pg/mL, respectively. Neck CT revealed a cystic mass and a contour bulging heterogeneous mass in the left inferior right thyroid gland, respectively. These mass lesions were removed, and the intra-operative parathyroid hormone levels monitored, to confirm the complete resection. After removing the left cystic mass to the inferior thyroid, the serum calcium and immunoreactive parathyroid hormone levels quickly returned to normal.
We report a case of primary hyperparathyroidism, caused by a cystic parathyroid adenoma, with a brief review of the literature.

Keywords: Hyperparathyroidism, Parathyroid cyst, Intra-operative parathyroid hormone level

Figures and Tables

Fig. 1
Neck sonogram shows complicated cystic mass in the inferior pole of the left thyroid gland and heterogenous, slightly echogenic mass in the inferior pole of the right thyroid gland.
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Fig. 2
Neck CT scan shows 3×2×1.5 cm cystic mass in the inferior pole of the left thyroid gland, contour bulging mass in the inferior pole of the right thyroid gland and multiple tiny cysts in both thyroid glands.
jkse-20-278-g002
Fig. 3
Tc99m-Sestamibi scan shows no increased abnormal radioactivity after 90min delayed image.
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Fig. 4
We removed cystic mass in the inferior pole of the left thyroid gland
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Fig. 5
The pathologic finding of left cystic mass is appropriate to parathyroid cystic adenoma. It is composed of chief cell (H&E ×100)
jkse-20-278-g005

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