A case report of secondary parathyroid adenomatous hyperplasia with carcinoma

Abstract

Introduction: Secondary parathyroid hyperplasia canceration is very rare and thus easily be overlooked during parathyroid ultrasound examination. However, secondary parathyroid hyperplasia still has the possibility of canceration, and it is still important to be alert to its occurrence when performing ultrasound examinations and clinical treatment.Patient concerns: A 49-years-old man visited our outpatient department with generalized weakness and pain in both lower extremities a month ago.Diagnosis: Hyperparathyroidism secondary to chronic renal failure. Interventions:The patient underwent ultrasound and other preoperative examinations. The preoperative ultrasound showed 3 parathyroid enlargements, 2 on the left and 1 on the right. The patient then underwent surgical treatment.Outcomes: Ultrasonography suggested the presence of 3 parathyroid hyperplasias, and ectopic right inferior parathyroid gland was visible during intraoperative examination. 10 days after surgery, the patient's Parathyroid Hormone returned to the normal range. Conclusion:Secondary parathyroid hyperplasia has the potential to become cancerous, so doctors should be alert to its occurrence when conducting ultrasound examinations. Ultrasound examination is the key to its diagnosis and subsequent treatment.

Coincidence or Causality: Parathyroid Carcinoma in Chronic Kidney Disease—Case Report and Literature Review

“…Classically, very high calcium levels above 14–15 mg/dL accompanied by PTH levels more than five times above the upper normal limit, high ALP > 285 IU/L, significantly decreased 1/3 radius BMD or gland diameter > 3 cm should raise the suspicion of PC in PHPT patients [ 1 , 15 , 46 , 63 ]. However, these features do not apply to SHPT, where nodular hyperplasia can reach significant enlargement, the serum levels of ALP and PTH are highly elevated, and 1/3 radius BMD is compromised.…”