Recurrent primary hyperparathyroidism : A diagnostic and management dilemma
Journal article
Wilkinson, Ben, Wan Muhamad Hatta, Sharifah Faradila, Garnham, Andrew Peter and Buch, Harit N.. (2021). Recurrent primary hyperparathyroidism : A diagnostic and management dilemma. Endocrinology, Diabetes and Metabolism Case Reports. 2021(1), pp. 1-5. https://doi.org/10.1530/EDM-20-0136
Authors | Wilkinson, Ben, Wan Muhamad Hatta, Sharifah Faradila, Garnham, Andrew Peter and Buch, Harit N. |
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Abstract | Primary hyperparathyroidism requires a surgical approach to achieve a long-term cure. However, post-surgical recurrence significantly complicates the management of this condition. A number of causes for recurrent disease are well understood and several diagnostic modalities exist to localise the culprit parathyroid adenoma although none of them is efficacious in localisation of the recurrent lesion. In this case report, we highlight a novel causative mechanism and describe a unique diagnostic sequence that enabled curative treatment to be delivered. Learning points: In the case described herein, we describe a novel location for a parathyroid adenoma causing recurrent PHPT. The case elucidates well the difficulties presented by such cases in terms of surgical planning and show the utility of PVS in such cases. Based on this case, we make the following recommendations: Meticulous care must be taken to prevent seeding of adenomatous tissue during primary excision. To consider the use of PVS in patients with discordant imaging in the setting of recurrent/persistent PHPT as a method to localise the causative adenoma. Same day PVS and surgery is a viable option for patients who either represent an anaesthetic risk or who are extremely anxious about the prospect of two separate procedures. Disordered calcium homeostasis is an important but forgotten cause of dysphagia which can be extremely debilitating for affected patients. |
Keywords | Adult; Male; White; United Kingdom; Parathyroid; Mineral; Radiology; Rheumatology; Surgery |
Year | 01 Jan 2021 |
Journal | Endocrinology, Diabetes and Metabolism Case Reports |
Journal citation | 2021 (1), pp. 1-5 |
Publisher | BioScientifica Ltd. |
ISSN | 2052-0573 |
Digital Object Identifier (DOI) | https://doi.org/10.1530/EDM-20-0136 |
Web address (URL) | https://edm.bioscientifica.com/view/journals/edm/2021/1/EDM20-0136.xml |
Open access | Published as non-open access |
Research or scholarly | Research |
Page range | 1-5 |
Publisher's version | License File Access Level Open |
Output status | Published |
Publication dates | |
Online | 27 Apr 2021 |
Publication process dates | |
Deposited | 15 Nov 2024 |
Additional information | © 2021 The authors |
This work is licensed under a Creative Commons | |
Place of publication | United Kingdom |
https://acuresearchbank.acu.edu.au/item/910zx/recurrent-primary-hyperparathyroidism-a-diagnostic-and-management-dilemma
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Publisher's version
OA_2021_Garnham_Recurrent_primary_hyperparathyroidism_A_diagnostic_and.pdf | |
License: CC BY-NC-ND 4.0 | |
File access level: Open |
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