Abstract
We report an adult male with the sole condition of recurrent nephrolithiasis, with no other associated symptoms nor family history, who was later diagnosed with Primary Hyperparathyroidism due to a giant right superior parathyroid adenoma. To the best of our knowledge, this is one of the few well-documented cases of this rare presentation in a male patient of the Dominican Republic. This case should affect the practice of physicians who interact with primary hyperparathyroidism and are involved in their management.
Highlights
Giant parathyroid adenomas are rarely encountered among patients with primary hyperparathyroidism and are known to present with distinct clinical and biochemical features that differ from typical parathyroid adenomas
To the best of our knowledge, this case report describes the first case reported in the Dominican Republic of a patient with Giant Parathyroid Adenoma (GPTA)
We report an adult male with the sole condition of recurrent nephrolithiasis, with no other associated symptoms nor family history, who was later diagnosed with Primary Hyperparathyroidism due to a giant right superior parathyroid adenoma
Summary
It is of great importance for physicians to have awareness that while most giant parathyroid adenomas tend to present higher levels of calcium and PTH, there seems to be a lower incidence of symptoms despite the hypercalcemic state, and should be promptly considered in a mildly symptomatic patient with hypercalcemia. These patients are more likely to develop symptomatic hypocalcemia after the resection of the adenoma. This case supports the effectiveness of minimally invasive techniques, which include a selective approach to the affected gland, together with intraoperative measurement of parathyroid hormone, as it is effective, less invasive, and precise
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