A parathyroid adenoma masquerading as an oesophageal cyst.
Gina Michelle Spencer, Christopher Joseph Chin
✦ AI-curated · Sources linked
Case in brief
A male in his 60s presented with ventricular fibrillation arrest, severe hypercalcaemia, and elevated parathyroid hormone levels, leading to a suspicion of primary hyperparathyroidism. Initial imaging could not localize the suspected parathyroid adenoma, and a mediastinal cystic mass was misidentified as an unrelated duplication cyst. An exploratory parathyroidectomy was performed, revealing the cyst to be a parathyroid adenoma, highlighting the need for thorough imaging in atypical cases.
What made this case unusual
The parathyroid adenoma presented as a mediastinal cystic mass adjacent to the oesophagus, which is an atypical presentation for this condition.
Diagnostic / clinical pearl
Clinicians should consider the possibility of a parathyroid adenoma in cases of primary hyperparathyroidism, even when imaging suggests an unrelated mediastinal mass.
Why it matters
This case emphasizes the necessity of utilizing multiple imaging modalities for accurate preoperative localization in atypical presentations of primary hyperparathyroidism.