Cystic parathyroid adenoma: An unusual cause of hypercalcemic crisis

Abstract

Parathyroid crisis is a rare clinical entity characterized by life-threatening hypercalcemia of a sudden onset in patients with primary hyperparathyroidism (pHTP) and rarely results from a cystic adenoma. We describe a 53-year-old woman with acute hypercalcemic crisis who presented with severe gastrointestinal symptoms. She had severe hypercalcemia (calcium level: 18.6 mg/dl) in conjunction with an elevated parathyroid hormone level of 1063 pg/ml. Ultrasonography of the neck revealed a 25x15 mm partly cystic mass at the superior pole of the right thyroid lobe. The patient underwent surgery immediately because hypercalcemia could not be controlled with medical treatment. The pathologic diagnosis was a cystic parathyroid adenoma.