Severe primary hyperparathyroîdism related multiple clear cell adenome
Khiari Karima, Hadj Ali Insaf, Lakhoua Youssef, Mchirgui Nadia, Cheikhrouhou Hela & Ben Abdallah Nejib
We report a 25 years old man who admitted in our department for primary hyperparathyroidism. He has previously been diagnosed with urolithiasis in 2006 and two pathological fracture of the humerus in 2009.
Physical exam was normal laboratory findings showed hypercalcemia (4.06 mmol/l) associated to a high parathyroid hormone level (PTH: 1930 pg/ml).
Ultrasound examination of the neck showed two enlarged parathyroid adenoma.
Surgical exploration noted three adenoma witch are excised.
Histopathological examination showed clear cell adenoma. The postoperative course was marqued by persistent hyperparathyroidism (calcemia: 2.62 mmol/l, PTH: 410.3 pg/ml). Imaging studies (scintigraphy and magnetic resonance imaging) showed a parathyroid adenoma in the posterior on the left lobe of the thyroid. The excised parathyroid was larged adenoma (clear cell adenoma). The postoperative course was excellent and serum PTH, calcemia levels returned to normal. There are no found argument for multiple endocrine neoplasias in our patient.
In summary, we report a rare case of severe primary hyperparathyroidism caused by multiple clear cell parathyroid adenoma.