SummaryA 51-year-old Filipino woman presenting with hypertension was unexpectedly found to have a large right adrenal mass by ultrasound. As she did not have symptoms of adrenal disease, this was labelled an adrenal incidentaloma. Ultrasound and CT imaging demonstrated a large adrenal mass on the right measuring 15 cm at its greatest diameter, with both benign and malignant features. Tests for endocrine hyperfunction (excess of cortisol, catecholamines and aldosterone) concluded that the mass was hormonally non-functioning. The patient eventually underwent open adrenalectomy. Histopathological examination revealed myelolipoma.
BACKGROUND
This is a case of a 44-year-old woman with an anterior neck mass and hypothyroidism who presented with an incidental finding of an elevated serum calcium level and was found to have primary hyperparathyroidism and osteoporosis. During surgical exploration no parathyroid adenoma was found, although a nodule was palpated within the right thyroid lobe. Examination of the excised right thyroid lobe revealed an intrathyroidal parathyroid adenoma and chronic lymphocytic thyroiditis. After surgery, she did not develop severe hypocalcaemia and this was attributed to preoperative treatment with pamidronate. In the months following surgery, parathyroid hormone remained undetectable.
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