A Case Report and Literature Review of a Giant Parathyroid Adenoma with Digestive System Symptoms and Brown Tumor

Abstract

Background: A parathyroid adenoma stands as the primary cause of primary hyperparathyroidism, and clinically it often presents with symptoms such as elevated blood calcium levels and recurrent kidney stones. Parathyroid adenoma discovered due to symptoms such as nausea and vomiting is relatively rare. Case presentation: A 59-year-old woman was hospitalized due to symptoms of nausea and vomiting. Imaging studies unveiled a solid mass located on the posterior aspect of the left thyroid lobe, potentially of parathyroid origin, along with multiple bone destruction throughout the body. Laboratory tests showed elevated serum total calcium, low potassium, and increased parathyroid hormone levels. The final diagnosis was primary hyperparathyroidism complicated by the brown tumor. Symptomatic treatment, including calcium reduction, fluid replacement, and electrolyte supplementation, was initiated. Subsequently, parathyroid adenoma resection was performed. Postoperatively, the patient developed hungry bone syndrome, which was treated with calcium supplementation, and follow-up showed normalization of blood calcium levels. Conclusions: Unexplained nausea accompanied by electrolyte disturbances should raise suspicion of rare causes such as primary hyperparathyroidism. When there are multiple systemic osteolytic changes, brown tumor should be considered, along with assessment of serum calcium and parathyroid hormone levels for diagnosis.