Late Recurrence of Hyperparathyroidism: Parathyromatosis or Recurrent Parathyroid Carcinoma?

A middle-aged woman presented with elevated calcium (10.7 mg/dL [0.28 mmol/L]) and parathyroid hormone (131 pg/mL [4,663.6 pmol/L]) levels. A sestamibi scan exhibited a right upper parathyroid lesion. Parathyroidectomy revealed a 3152 mg right upper parathyroid gland and the intraoperative parathyroid hormone level decreased by 90% (from 27.1 to 2.6 pmol/L; reference range, 1.3-6.8 pmol/L). The lesion was removed intact without any “spillage.” Histology revealed hypercellular parathyroid with intravascular tumor clusters at the periphery of the main lesion.
Source: Mayo Clinic Proceedings - Category: Internal Medicine Authors: Tags: Medical image Source Type: research