Case report: incidental parathyroid adenoma in a Chinese diabetic patient with hypercalcemia and normal parathyroid hormone levels. Issue 28 (July 2018)

• Record Type: Journal Article
• Authors: Pang, Can; Fan, Youben; Zhang, Huizheng; Yu, Haoyong; Guo, Bomin; Kang, Jie; Deng, Xianzhao; Bao, Yuqian
• Other Names: NA. section editor.
• Is Part Of: Medicine. Volume 97:Issue 28(2018)
• Publication Date: 2018-07
• Subjects: hypercalcemia -- parathyroid adenoma -- parathyroid hormone -- primary hyperparathyroidism; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000011333
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: Rationale: Parathyroid hormone PTH) levels are the main parameters to differentiate primary hyperparathyroidism (PHPT) from non-PTH-dependent hypercalcemia. We report a case of hypercalcemia with normal PTH levels due to a parathyroid adenoma. Patient concerns: A 52-year-old female patient presented with 2-year history of documented sustained high-normal serum calcium and hypercalcemia (2.51–3.03 mmol/L) with normal serum intact PTH levels (21.95–40.15 pg/ mL). Diagnoses: A parathyroid tumor was localized by ultrasonography and 99mTc-sestamibi dual-phase fusion imaging with single-photon emission computed tomography/computed tomography. Interventions: Parathyroidectomy was performed to excise the tumor completely. Outcomes: A 1.2-cm-sized parathyroid adenoma was removed surgically. The serum calcium was declined to normal level immediately after resection, as well as in 4- month follow-ups. The immunohistological diagnosis proved to be a PTH positive parathyroid adenoma. Lessons: In case of hypercalcemia, serum intact PTH and parathyroid imaging should be monitored to evaluate the presence of parathyroid adenoma with care because PHPT could present with inappropriate normal PTH.