An Uncommon Presentation Severe Hypercalcemia Linked to Cystic Parathyroid Adenoma Despite Negative Sestamibi Scan: A Case Report
Cystic parathyroid adenomas are uncommon occurrences, constituting approximately 1-2%, of primary hyperparathyroidism cases. They frequently pose diagnostic difficulties due to their limited detection in sestamibi scans. These cases of primary hyperparathyroidism commonly manifest with hypercalcemi...
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Nepal Medical Association
2025-07-01
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| Series: | Journal of Nepal Medical Association |
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| Online Access: | https://www.jnma.com.np/jnma/index.php/jnma/article/view/9170 |
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| author | Smriti Acharya Sharon Daniel Suyash Acharya Rajinder Gupta Daniel Kannappan |
| author_facet | Smriti Acharya Sharon Daniel Suyash Acharya Rajinder Gupta Daniel Kannappan |
| author_sort | Smriti Acharya |
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Cystic parathyroid adenomas are uncommon occurrences, constituting approximately 1-2%, of primary hyperparathyroidism cases. They frequently pose diagnostic difficulties due to their limited detection in sestamibi scans. These cases of primary hyperparathyroidism commonly manifest with hypercalcemic crisis
despite negative scan results. I present a rare scenario involving an elderly male who arrived at the emergency department with a swollen left neck, primarily due to a thyroid cyst causing breathing difficulties. Incidentally, hypercalcemia was also discovered during examination. Thorough investigations ensued, leading to the decision to perform a right hemithyroidectomy to address the large thyroid cyst and a parathyroidectomy. Histopathological analysis confirmed the presence of a cystic parathyroid adenoma, with subsequent normalization of calcium levels. Following the procedures, the patient experienced hypocalcemia and required calcium supplementation. This case stands out due to the high levels of parathyroid hormone, which typically raises suspicion for parathyroid carcinoma, making it a unique diagnostic challenge.
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| format | Article |
| id | doaj-art-c1e561d78ded4ad89ec91defcefe953c |
| institution | Kabale University |
| issn | 0028-2715 1815-672X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Nepal Medical Association |
| record_format | Article |
| series | Journal of Nepal Medical Association |
| spelling | doaj-art-c1e561d78ded4ad89ec91defcefe953c2025-08-20T04:02:28ZengNepal Medical AssociationJournal of Nepal Medical Association0028-27151815-672X2025-07-016328810.31729/jnma.9170An Uncommon Presentation Severe Hypercalcemia Linked to Cystic Parathyroid Adenoma Despite Negative Sestamibi Scan: A Case ReportSmriti Acharya0Sharon Daniel1Suyash Acharya2Rajinder Gupta3Daniel Kannappan4Registrar, Diabetes and Endocrinology, WWL NHS Foundation Trust, Wigan, United KingdomJunior clinical fellow, Diabetes and Endocrinology, WWL NHS Foundation Trust, Wigan , United KingdomJunior clinical fellow, Diabetes and Endocrinology, WWL NHS Foundation Trust, Wigan , United KingdomConsultant, Diabetes and Endocrinology, WWL NHS Foundation Trust, Wigan, United KingdomConsultant, Diabetes and Endocrinology, WWL NHS Foundation Trust, Wigan, United Kingdom Cystic parathyroid adenomas are uncommon occurrences, constituting approximately 1-2%, of primary hyperparathyroidism cases. They frequently pose diagnostic difficulties due to their limited detection in sestamibi scans. These cases of primary hyperparathyroidism commonly manifest with hypercalcemic crisis despite negative scan results. I present a rare scenario involving an elderly male who arrived at the emergency department with a swollen left neck, primarily due to a thyroid cyst causing breathing difficulties. Incidentally, hypercalcemia was also discovered during examination. Thorough investigations ensued, leading to the decision to perform a right hemithyroidectomy to address the large thyroid cyst and a parathyroidectomy. Histopathological analysis confirmed the presence of a cystic parathyroid adenoma, with subsequent normalization of calcium levels. Following the procedures, the patient experienced hypocalcemia and required calcium supplementation. This case stands out due to the high levels of parathyroid hormone, which typically raises suspicion for parathyroid carcinoma, making it a unique diagnostic challenge. https://www.jnma.com.np/jnma/index.php/jnma/article/view/9170adenomahypercalcemiahyperparathyroidismparathyroid |
| spellingShingle | Smriti Acharya Sharon Daniel Suyash Acharya Rajinder Gupta Daniel Kannappan An Uncommon Presentation Severe Hypercalcemia Linked to Cystic Parathyroid Adenoma Despite Negative Sestamibi Scan: A Case Report Journal of Nepal Medical Association adenoma hypercalcemia hyperparathyroidism parathyroid |
| title | An Uncommon Presentation Severe Hypercalcemia Linked to Cystic Parathyroid Adenoma Despite Negative Sestamibi Scan: A Case Report |
| title_full | An Uncommon Presentation Severe Hypercalcemia Linked to Cystic Parathyroid Adenoma Despite Negative Sestamibi Scan: A Case Report |
| title_fullStr | An Uncommon Presentation Severe Hypercalcemia Linked to Cystic Parathyroid Adenoma Despite Negative Sestamibi Scan: A Case Report |
| title_full_unstemmed | An Uncommon Presentation Severe Hypercalcemia Linked to Cystic Parathyroid Adenoma Despite Negative Sestamibi Scan: A Case Report |
| title_short | An Uncommon Presentation Severe Hypercalcemia Linked to Cystic Parathyroid Adenoma Despite Negative Sestamibi Scan: A Case Report |
| title_sort | uncommon presentation severe hypercalcemia linked to cystic parathyroid adenoma despite negative sestamibi scan a case report |
| topic | adenoma hypercalcemia hyperparathyroidism parathyroid |
| url | https://www.jnma.com.np/jnma/index.php/jnma/article/view/9170 |
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