Case report of a cystic parathyroidal adenoma with rapid growth induced by cinacalcet.

Abstract:

BACKGROUND:Primary hyperparathyroidism is a rare condition of disease which can seldomly present as giant retrotrhyroideal cysts, complicating the localization of the adenoma to resect. CASE PRESENTATION:A 56-year old female presented with hypercalcaemia of 3.38 mmol/L (2.2-2.65 mmol/L) and a history of breast cancer. A fast growing cystic parathyroidal adenoma was diagnosed by a multimodal approach including comprehensive diagnostic imaging (ultrasonography, scintigraphies, dynamic MRI) and cytopathological investigations after ultrasonography-guided puncture. The patient was cured by surgical extraction of the whole adenoma. In retrospect, the rapid growth was most likely induced by cinacalcet (initially 30 mg/d, later 60 mg/d) therapy which the patient received for few months only. Primary hyperparathyroidism was ascertained because surgical removal of the solitary adenoma cured the patient. Furthermore, there was no relevant renal insufficiency or history of prolonged calcium-level deregulation. CONCLUSIONS:This phenomenon of cystic degeneration of parathyroidal adenoma under therapy with cinacalcet has previously been described in secondary hyperparathyroidism, but not in primary hyperparathyroidism and should be considered in diagnostic approach.

journal_name

BMC Endocr Disord

journal_title

BMC endocrine disorders

authors

Werner C,Lupp A,Mtuka-Pardon G,Kloos C,Wolf G,Aschenbach R,Biermann A,Freesmeyer M,Seifert P

doi

10.1186/s12902-020-0532-7

subject

Has Abstract

pub_date

2020-04-20 00:00:00

pages

53

issue

1

issn

1472-6823

pii

10.1186/s12902-020-0532-7

journal_volume

20

pub_type

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