{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T02:58:09Z","timestamp":1789268289964,"version":"build-2803163510"},"reference-count":7,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","license":[{"start":{"date-parts":[[2013,1,1]],"date-time":"2013-01-01T00:00:00Z","timestamp":1356998400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2013,8,2]],"date-time":"2013-08-02T00:00:00Z","timestamp":1375401600000},"content-version":"vor","delay-in-days":213,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2013,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>INTRODUCTION:<\/jats:title>\n                    <jats:p>Primary hyperparathyroidism is a common endocrine disorder, with an incidence of 21.6 per 100,000 person-years. Asymptomatic elevated serum calcium levels on routine biochemical investigations accounts for 80% of newly diagnosed primary hyperparathyroidism. Solitary adenoma is the commonest cause of primary hyperparathyroidism and can be treated by excision of a single gland.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PRESENTATION OF CASE:<\/jats:title>\n                    <jats:p>We present a case of primary hyperparathyroidism in a 74-year-old female was referred to our surgery endocrine outpatients for assessment of a persistently elevated calcium level, lower abdominal pain and constipation. Biochemical analysis revealed corrected serum calcium of 3.13 mmol\/L (reference range 2.17\u20132.51 mmol\/L) and an intact parathyroid hormone level (iPTH) of 488.9 ng\/L (reference range 15\u201365 ng\/L). Sestamibi scan localised a persistent increased area of activity inferior to the lower pole of the left lobe of thyroid gland.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION:<\/jats:title>\n                    <jats:p>The patient underwent a minimally invasive parathyroidectomy using a 3 cm incision with intra-op radionucliotide localisation. At surgery a single large parathyroid gland measuring 5.5 cm was excised without complication. Grossly the parathyroid gland was an encapsulated tan mass measuring 5.5 cm \u00d7 2.5 cm \u00d7 2 cm and weight 13 g and histological assessment revealed a water-clear cell (WCC) adenoma. She made an uneventful post op recovery with normalisation of her serum calcium.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION:<\/jats:title>\n                    <jats:p>WCC adenomas have a \u201clow endocrinological activity\u201d in which serum calcium levels do not elevate until the adenoma has reached considerable size. Our case supports this hypothesis and aids to the understanding of these rare tumours.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2013.07.016","type":"journal-article","created":{"date-parts":[[2013,8,2]],"date-time":"2013-08-02T22:00:17Z","timestamp":1375480817000},"page":"911-913","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":16,"title":["Water-clear cell adenoma"],"prefix":"10.1097","volume":"4","author":[{"given":"R.P.","family":"Piggott","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.S.","family":"Waters","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Ashraf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Colesky","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.J.","family":"Kerin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-34-20260114","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1359\/JBMR.050910","article-title":"Incidence of primary hyperparathyroidism in Rochester, Minnesota, 1993\u20132001: an update on the changing epidemiology of the disease","volume":"21","author":"Wermers","year":"2006","journal-title":"Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research"},{"key":"R2-34-20260114","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1016\/S0046-8177(84)80306-8","article-title":"Functioning oxyphil cell adenoma of the parathyroid gland: a clinicopathologic study of ten patients with hyperparathyroidism","volume":"15","author":"Bedetti","year":"1984","journal-title":"Human Pathology"},{"key":"R3-34-20260114","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1507\/endocrj.51.207","article-title":"A rare case of primary hyperparathyroidism with clear cell adenoma","volume":"51","author":"Kanda","year":"2004","journal-title":"Endocrine Journal"},{"key":"R4-34-20260114","first-page":"275","article-title":"Large clear cell adenoma of the parathyroid in a patient with MEN-1 syndrome. Ultrastructural study of the tumour exhibiting unusual RER formations","volume":"45","author":"Kovacs","year":"1994","journal-title":"Acta Biologica Hungarica"},{"key":"R6-34-20260114","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1001\/archinte.1934.00160150002001","article-title":"Hyperparathyroidism due to diffuse hyperplasia of all parathyroid glands rather than adenoma of one: clinical studies on three such cases","volume":"54","author":"Albright","year":"1934","journal-title":"Archives of Internal Medicine"},{"key":"R7-34-20260114","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1097\/SLA.0b013e318208fed9","article-title":"The superiority of minimally invasive parathyroidectomy based on 1650 consecutive patients with primary hyperparathyroidism","volume":"253","author":"Udelsman","year":"2011","journal-title":"Annals of Surgery"},{"key":"R8-34-20260114","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1016\/j.surg.2012.08.022","article-title":"Is minimally invasive parathyroidectomy associated with greater recurrence compared to bilateral exploration? Analysis of more than 1000 cases","volume":"152","author":"Schneider","year":"2012","journal-title":"Surgery"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261213002319?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261213002319?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/01612930-201304100-00034","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T13:28:42Z","timestamp":1768397322000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01612930-201304100-00034"}},"subtitle":["A rare form of hyperparathyroidism"],"short-title":[],"issued":{"date-parts":[[2013,1]]},"references-count":7,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2013]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2013.07.016","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2013,1]]}}}