{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T20:44:45Z","timestamp":1790801085845,"version":"4.1.0"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,11,14]],"date-time":"2019-11-14T00:00:00Z","timestamp":1573689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,11,14]],"date-time":"2019-11-14T00:00:00Z","timestamp":1573689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Giant parathyroid adenoma is a rare type of parathyroid adenoma defined as weighing &gt;\u20093.5\u2009g. They present as primary hyperparathyroidism but with more elevated laboratory findings and more severe clinical presentations due to the larger tissue mass. This is the first reported case of giant parathyroid adenoma from\u00a0the Middle East.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Case presentation<\/jats:title>\n<jats:p>A 52-year-old Indian woman presented with a palpable right-sided neck mass and generalized fatigue. Investigations revealed hypercalcemia with elevated parathyroid hormone and an asymptomatic kidney stone. Ultrasound showed a complex nodule with solid and cystic components, and Sestamibi nuclear scan confirmed a giant parathyroid adenoma. Focused surgical neck exploration was done and a giant parathyroid adenoma weighing 7.7 gm was excised.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Giant parathyroid adenoma is a rare cause of primary hyperparathyroidism and usually presents symptomatically\u00a0with high calcium and parathyroid hormone levels. Giant parathyroid adenoma is diagnosed by imaging and laboratory studies. Management is typically surgical, aiming at complete resection. Patients usually recover with no long-term complications or recurrence.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s13256-019-2257-7","type":"journal-article","created":{"date-parts":[[2019,11,14]],"date-time":"2019-11-14T01:02:42Z","timestamp":1573693362000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Giant parathyroid adenoma: a case report and review of the literature"],"prefix":"10.1186","volume":"13","author":[{"given":"Mohamed S.","family":"Al-Hassan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Menatalla","family":"Mekhaimar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walid","family":"El Ansari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adham","family":"Darweesh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdelrahman","family":"Abdelaal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,11,14]]},"reference":[{"issue":"2 Suppl","key":"2257_CR1","first-page":"669","volume":"55","author":"RM Neagoe","year":"2014","unstructured":"Neagoe RM, Sala DT, Borda A, Mogoanta CA, Muhlfay G. Clinicopathologic and therapeutic aspects of giant parathyroid adenomas - three case reports and short review of the literature. Romanian J Morphol Embryol. 2014;55(2 Suppl):669\u201374.","journal-title":"Romanian J Morphol Embryol"},{"issue":"4","key":"2257_CR2","doi-asserted-by":"publisher","first-page":"714","DOI":"10.1016\/j.surg.2013.05.013","volume":"154","author":"PM Spanheimer","year":"2013","unstructured":"Spanheimer PM, Stoltze AJ, Howe JR, Sugg SL, Lal G, Weigel RJ. Do giant parathyroid adenomas represent a distinct clinical entity? Surgery. 2013;154(4):714\u20138; discussion 8-9","journal-title":"Surgery."},{"issue":"3","key":"2257_CR3","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1007\/s00595-004-2902-6","volume":"35","author":"C Power","year":"2005","unstructured":"Power C, Kavanagh D, Hill AD, O'Higgins N, McDermott E. Unusual presentation of a giant parathyroid adenoma: report of a case. Surg Today. 2005;35(3):235\u20137.","journal-title":"Surg Today"},{"issue":"1","key":"2257_CR4","first-page":"58","volume":"32","author":"T Madkhali","year":"2016","unstructured":"Madkhali T, Alhefdhi A, Chen H, Elfenbein D. Primary hyperparathyroidism. Ulus Cerrahi Derg. 2016;32(1):58\u201366.","journal-title":"Ulus Cerrahi Derg"},{"issue":"4","key":"2257_CR5","doi-asserted-by":"publisher","first-page":"e64","DOI":"10.1308\/003588415X14181254789682","volume":"97","author":"G Garas","year":"2015","unstructured":"Garas G, Poulasouchidou M, Dimoulas A, Hytiroglou P, Kita M, Zacharakis E. Radiological considerations and surgical planning in the treatment of giant parathyroid adenomas. Ann R Coll Surg Engl. 2015;97(4):e64\u20136.","journal-title":"Ann R Coll Surg Engl"},{"issue":"10","key":"2257_CR6","doi-asserted-by":"publisher","first-page":"3561","DOI":"10.1210\/jc.2014-1413","volume":"99","author":"JP Bilezikian","year":"2014","unstructured":"Bilezikian JP, Brandi ML, Eastell R, Silverberg SJ, Udelsman R, Marcocci C, et al. Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the Fourth International Workshop. J Clin Endocrinol Metab. 2014;99(10):3561\u20139.","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"2257_CR7","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1186\/s13256-016-1078-1","volume":"10","author":"S Rutledge","year":"2016","unstructured":"Rutledge S, Harrison M, O'Connell M, O'Dwyer T, Byrne MM. Acute presentation of a giant intrathyroidal parathyroid adenoma: a case report. J Med Case Rep. 2016;10(1):286.","journal-title":"J Med Case Rep"},{"issue":"1","key":"2257_CR8","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1016\/j.surg.2012.04.003","volume":"154","author":"M Migliore","year":"2013","unstructured":"Migliore M, Pulvirenti G, Okatyeva V, Cannizzaro MA. Persistent hyperparathyroidism owing to a giant parathyroid adenoma in posterior mediastinum. Surgery. 2013;154(1):132\u20133.","journal-title":"Surgery"},{"issue":"5","key":"2257_CR9","doi-asserted-by":"publisher","first-page":"512","DOI":"10.1016\/j.amjmed.2018.01.003","volume":"131","author":"K Garuna Murthee","year":"2018","unstructured":"Garuna Murthee K, Tay WL, Soo KL, Swee DS. A Migratory Mishap: Giant Mediastinal Parathyroid Adenoma. Am J Med. 2018;131(5):512\u20136.","journal-title":"Am J Med"},{"issue":"2","key":"2257_CR10","doi-asserted-by":"publisher","first-page":"196","DOI":"10.4103\/0974-2700.96497","volume":"5","author":"R Vilallonga","year":"2012","unstructured":"Vilallonga R, Zafon C, Migone R, Baena JA. Giant intrathyroidal parathyroid adenoma. J Emerg Trauma Shock. 2012;5(2):196\u20138.","journal-title":"J Emerg Trauma Shock"},{"issue":"1\u20132","key":"2257_CR11","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1111\/j.1445-2197.2008.04815.x","volume":"79","author":"V Aggarwal","year":"2009","unstructured":"Aggarwal V, Mishra A, Bhargav PR, Ramakant P. Giant parathyroid adenoma. ANZ J Surg. 2009;79(1\u20132):91.","journal-title":"ANZ J Surg"},{"issue":"2","key":"2257_CR12","first-page":"101","volume":"9","author":"M Salehian","year":"2009","unstructured":"Salehian M, Namdari O, Mohammadi SS, Feazli YH. Primary hyperparathyroidism due to a giant parathyroid adenoma: a case report. Int J Endocrinol Metabol. 2009;9(2):101\u20135.","journal-title":"Int J Endocrinol Metabol"},{"issue":"Suppl 1","key":"2257_CR13","first-page":"21","volume":"75","author":"R Sisodiya","year":"2011","unstructured":"Sisodiya R, Kumar S, Palankar N, BVD. Case report on giant parathyroid adenoma with review of literature. Indian J Surg. 2011;75(Suppl 1):21\u20132.","journal-title":"Indian J Surg"},{"key":"2257_CR14","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/1472-6823-12-14","volume":"12","author":"A Asghar","year":"2012","unstructured":"Asghar A, Ikram M, Islam N. A case report: Giant cystic parathyroid adenoma presenting with parathyroid crisis after Vitamin D replacement. BMC Endocr Disord. 2012;12:14.","journal-title":"BMC Endocr Disord"},{"issue":"5","key":"2257_CR15","doi-asserted-by":"publisher","first-page":"e21","DOI":"10.1308\/003588414X13946184900480","volume":"96","author":"A Haldar","year":"2014","unstructured":"Haldar A, Thapar A, Khan S, Jenkins S. Day-case minimally invasive excision of a giant mediastinal parathyroid adenoma. Ann R Coll Surg Engl. 2014;96(5):e21\u20133.","journal-title":"Ann R Coll Surg Engl"},{"key":"2257_CR16","doi-asserted-by":"publisher","first-page":"36","DOI":"10.4103\/0972-3919.172355","volume":"31","author":"A Krishnamurthy","year":"2016","unstructured":"Krishnamurthy A, Raghunandan GC, Ramshankar V. A rare case of giant parathyroid adenoma presenting with recurrent episodes of pancreatitis. Indian J Nucl Med. 2016;31:36\u20138.","journal-title":"Indian J Nucl Med"},{"key":"2257_CR17","first-page":"1","volume":"2017","author":"MA Castro","year":"2017","unstructured":"Castro MA, L\u00f3pez AA, Fragueiro LM, Garc\u00eda NP. Giant parathyroid adenoma: differential aspects compared to parathyroid carcinoma. Endocrinol Diabetes Metab Case Rep. 2017;2017:1.","journal-title":"Endocrinol Diabetes Metab Case Rep"},{"key":"2257_CR18","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1016\/j.ijscr.2017.01.064","volume":"31","author":"G Sahsamanis","year":"2017","unstructured":"Sahsamanis G, Gkouzis K, Samaras S, Pinialidis D, Dimitrakopoulos G. Surgical management of a giant parathyroid adenoma through minimal invasive parathyroidectomy. A case report. Int J Surg Case Rep. 2017;31:262\u20135.","journal-title":"Int J Surg Case Rep"},{"key":"2257_CR19","doi-asserted-by":"publisher","first-page":"1334","DOI":"10.12659\/AJCR.911452","volume":"19","author":"I Mantzoros","year":"2018","unstructured":"Mantzoros I, Kyriakidou D, Galanos-Demiris K, Chatzakis C, Parpoudi S, Sapidis N, et al. A Rare Case of Primary Hyperparathyroidism Caused by a Giant Solitary Parathyroid Adenoma. Am J Case Rep. 2018;19:1334\u20137.","journal-title":"Am J Case Rep"},{"issue":"8","key":"2257_CR20","first-page":"547","volume":"54","author":"H Taghavi Kojidi","year":"2016","unstructured":"Taghavi Kojidi H, Vagharimehr N, Mohseni S, Pajouhi M, Mohajeri-Tehrani MR. Unusual Ectopic Parathyroid Adenoma: A Case Report. Acta Med Iran. 2016;54(8):547\u201350.","journal-title":"Acta Med Iran"},{"issue":"1","key":"2257_CR21","first-page":"70","volume":"5","author":"M Pecheva","year":"2016","unstructured":"Pecheva M, Mahendran K, Kadlec J, Lofthouse M, Van Tornout F. Mediastinal giant parathyroid adenoma-a minimally invasive mediastinal surgical approach for an emergency presentation. Ann Cardiothorac Surg. 2016;5(1):70\u20133.","journal-title":"Ann Cardiothorac Surg"},{"issue":"11","key":"2257_CR22","first-page":"bcr","volume":"2017","author":"S Talukder","year":"2017","unstructured":"Talukder S, Behera A, Bhadada SK, Mitra S. Giant mediastinal parathyroid adenoma presenting as bilateral brown tumour of mandible: a rare presentation of primary hyperparathyroidism. BMJ Case Rep. 2017;2017(11):bcr\u20132017.","journal-title":"BMJ Case Rep"},{"issue":"2","key":"2257_CR23","doi-asserted-by":"publisher","first-page":"bcr-2018-228292","DOI":"10.1136\/bcr-2018-228292","volume":"12","author":"Benjamin John Miller","year":"2019","unstructured":"Miller BJ, Isaacs K, Khan E, Palazzo FF. Transcervical excision of a giant mediastinal parathyroid adenoma. BMJ Case Rep. 2019;12(2) https:\/\/doi.org\/10.1136\/bcr-2018-228292.","journal-title":"BMJ Case Reports"},{"issue":"10","key":"2257_CR24","first-page":"592","volume":"58","author":"B Korukluoglu","year":"2008","unstructured":"Korukluoglu B, Ergul E, Yalcin S. Giant intrathyroidal parathyroid cystic adenoma. J Pak Med Assoc. 2008;58(10):592.","journal-title":"J Pak Med Assoc"},{"issue":"4","key":"2257_CR25","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1097\/01.rlu.0000257293.00744.3c","volume":"32","author":"S Desigan","year":"2007","unstructured":"Desigan S, Syed R, Conway GS, Kurzawinski TR, Bomanji JB. Giant cervical parathyroid adenoma mimicking a sternocleidomastoid mass and presenting as a brown tumor of the mandible. Clin Nucl Med. 2007;32(4):306\u20138.","journal-title":"Clin Nucl Med"},{"issue":"6","key":"2257_CR26","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1016\/0002-9610(86)90436-8","volume":"152","author":"WA Zamboni","year":"1986","unstructured":"Zamboni WA, Folse R. Adenoma weight: a predictor of transient hypocalcemia after parathyroidectomy. Am J Surg. 1986;152(6):611\u20135.","journal-title":"Am J Surg"},{"key":"2257_CR27","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1016\/j.jss.2018.12.021","volume":"237","author":"TE Abdel-Aziz","year":"2019","unstructured":"Abdel-Aziz TE, Gleeson F, Sadler G, Mihai R. Dwarfs and Giants of Parathyroid Adenomas-No Difference in Outcome After Parathyroidectomy. J Surg Res. 2019;237:56\u201360.","journal-title":"J Surg Res"},{"issue":"4 Suppl","key":"2257_CR28","doi-asserted-by":"publisher","first-page":"S38","DOI":"10.1016\/j.jamcollsurg.2007.06.322","volume":"205","author":"D Calva-Cerqueira","year":"2007","unstructured":"Calva-Cerqueira D, Smith BJ, Hostetler ML, Lal G, Menda Y, O'Dorisio TM, et al. Minimally invasive parathyroidectomy and preoperative MIBI scans: correlation of gland weight and preoperative PTH. J Am Coll Surg. 2007;205(4 Suppl):S38\u201344.","journal-title":"J Am Coll Surg"},{"issue":"5","key":"2257_CR29","doi-asserted-by":"publisher","first-page":"466","DOI":"10.4132\/KoreanJPathol.2013.47.5.466","volume":"47","author":"I Heo","year":"2013","unstructured":"Heo I, Park S, Jung CW, Koh JS, Lee SS, Seol H, et al. Fine needle aspiration cytology of parathyroid lesions. Korean J Pathol. 2013;47(5):466\u201371.","journal-title":"Korean J Pathol"},{"issue":"1","key":"2257_CR30","doi-asserted-by":"publisher","first-page":"17","DOI":"10.4103\/0970-9371.175490","volume":"33","author":"N Kumari","year":"2016","unstructured":"Kumari N, Mishra D, Pradhan R, Agarwal A, Krishnani N. Utility of fine-needle aspiration cytology in the identification of parathyroid lesions. J Cytol. 2016;33(1):17\u201321.","journal-title":"J Cytol"},{"issue":"3","key":"2257_CR31","doi-asserted-by":"publisher","first-page":"418","DOI":"10.1016\/j.amjsurg.2005.10.049","volume":"191","author":"R Phitayakorn","year":"2006","unstructured":"Phitayakorn R, McHenry CR. Incidence and location of ectopic abnormal parathyroid glands. Am J Surg. 2006;191(3):418\u201323.","journal-title":"Am J Surg"},{"key":"2257_CR32","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1016\/j.jss.2016.08.045","volume":"207","author":"M LoPinto","year":"2017","unstructured":"LoPinto M, Rubio GA, Khan ZF, Vaghaiwalla TM, Farra JC, Lew JI. Location of abnormal parathyroid glands: lessons from 810 parathyroidectomies. J Surg Res. 2017;207:22\u20136.","journal-title":"J Surg Res"},{"issue":"1","key":"2257_CR33","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1002\/bjs.5574","volume":"94","author":"R Mihai","year":"2007","unstructured":"Mihai R, Palazzo FF, Gleeson FV, Sadler GP. Minimally invasive parathyroidectomy without intraoperative parathyroid hormone monitoring in patients with primary hyperparathyroidism. Br J Surg. 2007;94(1):42\u20137.","journal-title":"Br J Surg"},{"issue":"3","key":"2257_CR34","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1016\/j.amsu.2015.08.007","volume":"4","author":"AA Khan","year":"2015","unstructured":"Khan AA, Khatun Y, Walker A, Jimeno J, Hubbard JG. Role of intraoperative PTH monitoring and surgical approach in primary hyperparathyroidism. Ann Med Surg (Lond). 2015;4(3):301\u20135.","journal-title":"Ann Med Surg (Lond)"}],"container-title":["Journal of Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-019-2257-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s13256-019-2257-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-019-2257-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,11,13]],"date-time":"2020-11-13T00:32:41Z","timestamp":1605227561000},"score":1,"resource":{"primary":{"URL":"https:\/\/jmedicalcasereports.biomedcentral.com\/articles\/10.1186\/s13256-019-2257-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,14]]},"references-count":34,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["2257"],"URL":"https:\/\/doi.org\/10.1186\/s13256-019-2257-7","relation":{},"ISSN":["1752-1947"],"issn-type":[{"value":"1752-1947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11,14]]},"assertion":[{"value":"11 June 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 September 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 November 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Ethics approval and consent to publish provided: Medical Research Centre review board, Institutional Review Board (IRB), protocol #0419113, Hamad Medical Corporation, Doha, Qatar.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Ethics approval and consent to publish provided (Medical Research Centre review board, IRB, #0419113, Hamad Medical Corporation, Doha, Qatar). Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"332"}}