Hypercalcemia in primary hyperparathyoidism: when should ENT be alerted?

May Ferjani; Mahdi Ferjaoui; Nour Kraiem; Nawres Bouaziz; Rachida Bouatay; Amel Korbi; Nawrez Kolsi; Khaled Harrathi; Jamel Koubaa

doi:10.1530/endoabs.110.EP195

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Endocrine Abstracts (2025) 110 EP195 | DOI: 10.1530/endoabs.110.EP195

ECEESPE2025 ePoster Presentations Bone and Mineral Metabolism (142 abstracts)

Hypercalcemia in primary hyperparathyoidism: when should ENT be alerted?

May Ferjani ¹ , Mahdi Ferjaoui ¹ , Nour Kraiem ¹ , Nawres Bouaziz ¹ , Rachida Bouatay ¹ , Amel Korbi ¹ , Nawrez Kolsi ¹ , Khaled Harrathi ¹ & Jamel Koubaa ¹

Author affiliations

¹Fattouma Bourguiba Hospital, ENT and Cervicofacial Surgery, Monastir, Tunisia

JOINT3413

Introduction: Primary hyperparathyroidism is the leading cause of hypercalcemia. It can be asymptomatic and discovered incidentally, or revealed by recurrent kidney stones, bone pain, or cardiac and digestive symptoms.

Materials and Methods: This retrospective study includes 22 cases of primary hyperparathyroidism treated with parathyroidectomy between 2021 and 2023.

Results: The study involved 22 patients, predominantly women, (M/F ratio: 0.18) with a mean age of 58.72 years. All patients had hypercalcemia with elevated parathyroid hormone (PTH) levels. The average preoperative calcium and PTH levels were 2.82 mmol/l and 389 pg/mL. Twenty-three percent of patients were asymptomatic, 45% reported bone pain, and 27% had a history of kidney stones. Other symptoms were present in 32% of patients. ENT examinationwas normal in 21 cases. One patient had a left paramedian anterior basicervical swelling, measuring 1 cm firm, mobile. Ultrasound suggested a retrothyroidal nodule, with some uncertainty regarding its origin. Scintigraphy confirmed the diagnosis in all cases. All patients underwent parathyroidectomy, with removal of the pathological parathyroid gland. Four patients also underwent a lobectomy for thyroid nodules. Histopathology revealed parathyroid adenoma in 86% and pseudo-adenomatous hyperplasia in 14% of the cases. Postoperative calcium and PTH levels decreased starting on postoperative day 2, with average values of 2.36 mmol/l and 39 pg/mL respectively.

Conclusion: Primary hyperparathyroidism remains the most common cause of hypercalcemia. The role of the ENT surgeon is crucial in the therapeutic management once the diagnosis is established. Postoperative outcomes following surgery are remarkable.