Hyperparathyroidism due to Eutopic PTH Secretion from an Ectopic Intrathymic Parathyroid Cyst

Wai Han Hoi, Melvin Khee-Shing Leow, Ashish Sule, Hwei Yee Lee, T Agasthian Mmed, Jam Chin Tay
2011 Annals of Thoracic and Cardiovascular Surgery  
Parathyroid cysts rarely cause hyperparathyroidism. In addition, they rarely occur in the thymus. We report a 56-year-old woman with hypertension on telmisartan and hydrochlorothiazide, who developed symptomatic hypercalcemia for a month. Initial serum calcium was 15.6 mg/dL, together with inappropriately elevated intact PTH at 437 pg/mL. Coincidentally, an anterior mediastinal mass on chest imaging was found. Biopsy of the mass revealed parathyroid tissue. She was treated sequentially with
more » ... ne rehydration and frusemide calciuresis, intravenous pamidronate and calcitonin, which lowered her calcium to 11.1 mg/dL. Normocalcemia was finally achieved following surgical extirpation of the mass. Histology confirmed an intrathymic parathyroid cyst. Definitive treatment by resection of the mass is potentially curative.
doi:10.5761/atcs.cr.10.01634 fatcat:cyoukisrtnhejegf6obzpfjlvi