{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T04:04:50Z","timestamp":1792037090004,"version":"4.4.0"},"reference-count":14,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,6,22]],"date-time":"2023-06-22T00:00:00Z","timestamp":1687392000000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec><jats:title>Key Clinical Message<\/jats:title><jats:p>Hyperparathyroidism is a common endocrine disorder, which must be suspected in patients presenting with fatigue, history of pathologic fracture and the diagnosis can be confirmed by elevated calcium and PTH levels, and the preferred treatment option.<\/jats:p><\/jats:sec><jats:sec><jats:title>Abstract<\/jats:title><jats:p>Primary hyperparathyroidism (PHPT), a common endocrine condition, with elevated parathormone production causes increased blood calcium levels. Parathyroid adenomas cause the majority of PHPT cases. Significant hypercalcemia can result from giant parathyroid adenomas. A calcium crisis may not always arise in these individuals, despite enormous parathyroid adenomas and high parathyroid hormone levels, and the masses may first be mistaken for a thyroid mass. In this article, we discuss the case of a 57\u2010year\u2010old Iranian man who suffered from PHPT due to a massive parathyroid adenoma and had a history of extreme fatigue and several traumatic fractures. As specialists, we should have a strong clinical suspicion of giant parathyroid adenoma as reason of hyperparathyroidism. In patients with multiple bone problems such as pain and multiple pathological fractures and elevated levels of calcium and PTH, the diagnosis of GPA must be considered and their preferred treatment is surgery.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccr3.7474","type":"journal-article","created":{"date-parts":[[2023,6,24]],"date-time":"2023-06-24T23:07:52Z","timestamp":1687648072000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Giant parathyroid adenoma presenting with multiple pathologic fractures: A case report"],"prefix":"10.1002","volume":"11","author":[{"given":"Hassan","family":"Abshirini","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, Imam Khomeini Hospital Jundishapur University of Medical Sciences  Ahvaz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2985-163X","authenticated-orcid":false,"given":"Mahsa","family":"Heidari","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Boalisina Hospital Mazandaran University of Medical Science  Sari Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8149-7490","authenticated-orcid":false,"given":"Ali","family":"Fahimi","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Boalisina Hospital Mazandaran University of Medical Science  Sari Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5077-7307","authenticated-orcid":false,"given":"Parastoo","family":"Ghorbani","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine Mazandaran University of Medical Science  Sari Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3903-0464","authenticated-orcid":false,"given":"Erfan","family":"Ghadirzadeh","sequence":"additional","affiliation":[{"name":"Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases Shahid Beheshti University of Medical Sciences  Tehran Iran"},{"name":"Cardiovascular Research Center Mazandaran University of Medical Sciences  Sari Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sasan","family":"Shafiei","sequence":"additional","affiliation":[{"name":"Skull Base Research Center, Loghman Hakim Hospital Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,6,22]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.5603\/EP.a2020.0028"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgac024"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1155\/2010\/357029"},{"key":"e_1_2_10_5_1","article-title":"Giant parathyroid adenoma: differential aspects compared to parathyroid carcinoma","volume":"2017","author":"Araujo Castro M","year":"2017","journal-title":"Endocrinol Diabetes Metab Case Rep"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13256-022-03401-y"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2013.05.013"},{"issue":"1","key":"e_1_2_10_8_1","first-page":"58","article-title":"Primary hyperparathyroidism","volume":"32","author":"Madkhali T","year":"2016","journal-title":"Ulus Cerrahi Derg"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/03000605221106419"},{"key":"e_1_2_10_10_1","article-title":"Giant parathyroid tumor: parathyroid adenoma versus parathyroid carcinoma","volume":"2022","author":"Gossili F","year":"2022","journal-title":"Case Rep Endocrinol"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2017.01.064"},{"issue":"1","key":"e_1_2_10_12_1","first-page":"73","article-title":"Normocalcemic parathyroid adenoma with Brown's tumor maxilla: a rare case","volume":"35","author":"Wadhawan A","year":"2023","journal-title":"Iran J Otorhinolaryngol"},{"key":"e_1_2_10_13_1","doi-asserted-by":"crossref","unstructured":"PokhrelB LeslieSW LevineSN.Primary hyperparathyroidism. In: das Neves MC Santos RO Ohe MN eds.StatPearls [Internet]. Vol 66. StatPearls Publishing;2022:678\u2010688.","DOI":"10.20945\/2359-3997000000557"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.6785"},{"issue":"2","key":"e_1_2_10_15_1","first-page":"85","article-title":"Surgical treatment of primary hyperparathyroidism: from bilateral neck exploration to minimally invasive surgery","volume":"33","author":"Pelizzo MR","year":"2008","journal-title":"Minerva Endocrinol"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.7474","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T16:00:57Z","timestamp":1692547257000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.7474"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6]]},"references-count":14,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1002\/ccr3.7474"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.7474","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6]]},"assertion":[{"value":"2023-04-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e7474"}}