Endocrinol Metab > Volume 22(4); 2007 > Article
Journal of Korean Endocrine Society 2007;22(4):292-298.
DOI: https://doi.org/10.3803/jkes.2007.22.4.292    Published online August 1, 2007.
A Case of Primary Hyperparathyroidism due to Cystic Parathyroid Adenoma Presenting as Hypercalcemic Crisis Associated with Intracranial Hemorrhage.
Jin Ook Chung, Gwi Hong Jeong, Se In Hong, Dong Hyeok Cho, Dong Jin Chung, Min Young Chung
Department of Internal Medicine, Chonnam National University Medical School.
Abstract
Most patients with hypercalcemia are asymptomatic or they have non-specific symptoms at diagnosis. Yet hypercalcemic crisis is a potentially fatal complication of hyperparathyroidism. Cystic parathyroid adenoma is a rare cause of primary hyperparathyroidism and hypercalcemic crisis. A 52-year-old woman was transferred to our hospital due to her relapsed drowsy mental state and renal insufficiency that occurred in course of her management for intracranial hemorrhage with manitol. The total serum calcium was 16.2 mg/dL and the intact parathyroid hormone was 546 pg/mL. Neck computed tomography showed a 3.1 x 1.8 cm sized cystic mass on the right thyroid lower pole. 99mTc-labelled sestamibi scintigraphy showed no significant uptake. In addition to prompt saline infusion and loop diuretics, the patient was given pamidronate to lower the serum calcium, and she was improved to an alert mental state with normal renal function. Surgical excision of the parathyroid cyst was performed. A histological examination confirmed a cystic parathyroid adenoma. The levels of plasma PTH and serum calcium were normalized after resection.
Key Words: Hypercalcemia, Intracranial hemorrhage, Parathyroid adenoma


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