Spontaneous Remission After a Hypercalcemic Crisis Caused by an Intracystic Hemorrhage of Bilateral Parathyroid Adenomas: A Case Report and Literature Review

Abstract

BackgroundHyperparathyroidism is a common cause of hypercalcemia; however, spontaneous remission after a hypercalcemic crisis caused by an intracystic hemorrhage of parathyroid adenomas is very rare. The question, then, is “What is the best treatment strategy for this type of case?”MethodA 47-year-old male patient with primary hyperparathyroidism and a hypercalcemic crisis is reported. Hypercalcemia was spontaneously relieved thereafter. Postoperative paraffin pathology results indicated an intracystic hemorrhage of bilateral parathyroid adenomas.ResultsAfter the case report, a literature review is also included to summarize the clinical features of this patient and to provide special reference for clinical diagnosis and treatment of similar cases.ConclusionsThe choice of surgical timing for such cases can be made based on the comprehensive consideration of clinical symptoms and changes in parathyroid function.

Multiple Bone Cysts Caused by Hyperparathyroidism: A Case Report and Review of the Literature

“…Marked elevation of PTH level is one of the limited factors for predicting parathyroid carcinoma, but the parathyroid tumor of the current patient was diagnosed as an adenoma by postoperative pathologic analysis. The necrotic region observed within the resected tumor was compatible with the clinical course suggesting parathyroid apoplexy, which, in many reported cases, does not lead to complete remission of hyperparathyroidism longterm (44,45). In the differential diagnosis of multiple cystic bone lesions, hyperparathyroidism should be considered, and laboratory data may be useful for differentiating brown tumors and other bone lesions.…”

Chirurgische Therapie kritischer Hyperkalzämien und hyperkalzämischer Krisen

“…Dies konnte in Einzelfalldarstellungen bestätigt werden. Miao et al [56] eine kritische Hyperkalzämie [4,43,42,58], die durch Resorption des Zysteninhalts bei sehr hohen PTH-Konzentrationen (bis > 500 000 pg/ml) erklärt werden kann [42].…”