Endocrinol Metab > Volume 24(4); 2009 > Article
Journal of Korean Endocrine Society 2009;24(4):260-264.
DOI: https://doi.org/10.3803/jkes.2009.24.4.260    Published online December 1, 2009.
A Case of Recurrent Ectopic Parathyroid Adenoma Developed 22 Years after the Initial Parathyroidectomy.
Yoon Jung Kim, Ji A Seo, Ji Mi Moon, Young Jin Seo, Hae Yoon Choi, Hye Sook Kim, Sin Gon Kim, Kyeung mook Choi, Sei Hyun Baik, Dong Seop Choi, Nan Hee Kim
Division of Endocrinology & Metabolism, Korea University Ansan Hospital, Ansan, Korea.
Abstract
Persistent or recurrent primary hyperparathyroidism after initial parathyroid surgery occurs at rates of 1.5~10%. A single missed parathyroid adenoma accounts for the majority of persistent hyperparathyroidism, whereas metachronous parathyroid adenoma is a rare cause of recurrent hypercalcemia. We report a case of a 39-year-old female who presented with recurrent pancreatitis. She had symptoms of hyperparathyroidism such as hypercalcemia, hypophosphatemia, hypercalciuria, nephrocalcinosis, and osteoporosis. She had a 2-cm firm neck mass under the right submandibular area. She was diagnosed with primary hyperparathyroidism 22 years ago. At that time, the right upper and lower parathyroid glands were removed after exploration of all parathyroid glands, and a right upper parathyroid adenoma was diagnosed. Now, she had a second surgery to remove the right submandibular mass with intraoperative PTH monitoring, which was diagnosed as a parathyroid adenoma in an ectopic supernumerary parathyroid gland. Because of hungry bone syndrome, she received calcium carbonate replacement therapy and has no evidence of recurrence. Here, we report a recurrent parathyroid adenoma in the undescended, supernumerary parathyroid gland after a long interval from the initial surgery.
Key Words: hyperparathyroidism, parathyroid adenoma, recur


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