Selective venous sampling in primary hyperparathyroidism caused by ectopic parathyroid gland: a case report and literature review

BMC Endocr Disord. 2023 Jul 6;23(1):141. doi: 10.1186/s12902-023-01376-5.

Abstract

Background: As an invasive technique, selective venous sampling (SVS) is considered a useful method to identify a lesion's location to increase the success rate of secondary surgery in patients with primary hyperparathyroidism (pHPT) caused by ectopic parathyroid adenomas.

Case presentation: We present a case of post-surgical persistent hypercalcemia and elevated parathyroid hormone (PTH) levels in a 44-year-old woman with previously undetected parathyroid adenoma. An SVS was then performed for further localization of the adenoma, as other non-invasive methods showed negative results. After SVS, an ectopic adenoma was suspected in the sheath of the left carotid artery, previously considered as a schwannoma, and was pathologically confirmed after the second operation. Postoperatively, the patient's symptoms disappeared and serum levels of PTH and calcium normalized.

Conclusions: SVS can provide precise diagnosis and accurate positioning before re-operation in patients with pHPT.

Keywords: Case report; Ectopic parathyroid gland; PTH; SVS; pHPT.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Adenoma* / complications
  • Adenoma* / diagnosis
  • Adenoma* / surgery
  • Adult
  • Calcium
  • Female
  • Humans
  • Hyperparathyroidism, Primary* / complications
  • Hyperparathyroidism, Primary* / diagnosis
  • Parathyroid Glands / surgery
  • Parathyroid Hormone
  • Parathyroid Neoplasms* / complications
  • Parathyroid Neoplasms* / diagnosis
  • Parathyroid Neoplasms* / surgery

Substances

  • Calcium
  • Parathyroid Hormone