Abstract
Introduction: Water-clear cell adenoma is a very rare neoplasm of the parathyroid gland. Very few cases have been reported so far in the medical literature. It is a well-documented cause of primary hyperparathyroidism. We here describe a case of Water-clear cell adenoma of the parathyroid gland in a 56-year-old male. Case presentation and results: The patient presented to hospital with hypercalcaemia and high parathyroid hormone (PTH) level. Sestamibi scan showed a hyper functioning parathyroid adenoma immediately behind the mid left lobe of thyroid. Surgical excision was done. The weight of the fresh specimen was 5.152 g. Histologically, a well circumscribed partially encapsulated hypercellular parathyroid tissue was identified, composed of a monotonous population of cells with clear cytoplasm arranged in trabecular pattern. High power examination revealed the lesional cells with abundant finely vacuolated cytoplasm, uniform nuclei and inconspicuous nucleoli. Immunohistochemical analysis demonstrated positive staining for PTH and chromogranin A. Conclusion: Water-clear cell variant of parathyroid adenoma is a rare pathological entity. It should be differentiated from metastatic conventional renal cell carcinoma, paraganglioma and clear cell changes in salivary gland tumours. Clinical correlation and Immunohistochemistry are helpful in arriving at the final diagnosis.
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