{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T06:44:35Z","timestamp":1791873875685,"version":"4.3.4"},"reference-count":11,"publisher":"The Endocrine Society","issue":"11","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"vor","delay-in-days":18,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Calcimimetics are increasingly used to control hypercalcemia before parathyroidectomy. Although treatment-induced degenerative changes have been reported in parathyroid adenomas, their effects on preoperative imaging and surgical planning remain unclear. A 70-year-old woman with primary hyperparathyroidism was administered preoperative evocalcet (2\u2005mg\/day). After \u223c2 months, serum calcium levels decreased to the hypocalcemic range, prompting drug discontinuation before surgery referral. Upon presentation, corrected serum calcium normalized to 9.1\u2005mg\/dL (SI: 2.28\u2005mmol\/L; reference range, 8.8-10.1\u2005mg\/dL [SI: 2.20-2.53\u2005mmol\/L]), whereas intact parathyroid hormone remained mildly elevated at 65.7\u2005pg\/mL (SI: 7.0\u2005pmol\/L; reference range, 10-65\u2005pg\/mL [SI: 1.1-6.9\u2005pmol\/L]). Ultrasonography revealed a right superior parathyroid lesion, with markedly decreased Doppler flow. Four-dimensional computed tomography revealed weak enhancement throughout the contrast-enhanced phase. Parathyroidectomy revealed marked fibrosis and dense adhesions around the recurrent laryngeal nerve, making dissection technically demanding, although the nerve was preserved. Histopathological examination confirmed parathyroid adenoma with extensive fibrosis, cystic degeneration, necrosis, and macrophage infiltration. Therefore, calcimimetic therapy may modify the radiological and histopathological characteristics of parathyroid adenomas and intraoperative findings relevant to surgical planning. Recognition of these treatment-induced changes may improve the interpretation of preoperative images, help surgeons anticipate dense adhesions, and facilitate meticulous surgical dissection.<\/jats:p>","DOI":"10.1210\/jcemcr\/luag310","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T11:59:23Z","timestamp":1790164763000},"source":"Crossref","is-referenced-by-count":0,"title":["Calcimimetic therapy modified the radiological, surgical, and histopathological features of a parathyroid adenoma"],"prefix":"10.1210","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-0805-8886","authenticated-orcid":false,"given":"Hiroyuki","family":"Yamashita","sequence":"first","affiliation":[{"name":"Department of Surgery, Yamashita Thyroid Hospital , Fukuoka 812-0034 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1424-620X","authenticated-orcid":false,"given":"Hisakazu","family":"Shindo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Yamashita Thyroid Hospital , Fukuoka 812-0034 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9802-3697","authenticated-orcid":false,"given":"Daisuke","family":"Tatsushima","sequence":"additional","affiliation":[{"name":"Department of Surgery, Yamashita Thyroid Hospital , Fukuoka 812-0034 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirokazu","family":"Kurohama","sequence":"additional","affiliation":[{"name":"Department of Tumor and Diagnostic Pathology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki 852-8523 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenichiro","family":"Koga","sequence":"additional","affiliation":[{"name":"Kokura Thyroid and Breast Clinic , Kitakyushu 802-0081 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9036-8735","authenticated-orcid":false,"given":"Masahiro","family":"Nakashima","sequence":"additional","affiliation":[{"name":"Department of Tumor and Diagnostic Pathology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki 852-8523 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"issue":"11","key":"2026101301462567900_luag310-B1","doi-asserted-by":"crossref","first-page":"3993","DOI":"10.1210\/jc.2018-01225","article-title":"Primary hyperparathyroidism","volume":"103","author":"Bilezikian","year":"2018","journal-title":"J Clin Endocrinol Metab"},{"key":"2026101301462567900_luag310-B2","article-title":"Contemporary medical management of primary hyperparathyroidism: a systematic review","volume":"8","author":"Leere","year":"2017","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"5","key":"2026101301462567900_luag310-B3","doi-asserted-by":"crossref","first-page":"689","DOI":"10.20945\/2359-3997000000558","article-title":"Medical management of primary hyperparathyroidism","volume":"66","author":"Bandeira","year":"2022","journal-title":"Arch Endocrinol Metab"},{"key":"2026101301462567900_luag310-B4","doi-asserted-by":"publisher","DOI":"10.1210\/jcemcr\/luag165","article-title":"Early parathyroid hormone elevation after denosumab therapy following parathyroidectomy: a diagnostic pitfall","author":"Yamashita","year":"2026","journal-title":"JCEM Case Rep"},{"issue":"8","key":"2026101301462567900_luag310-B5","article-title":"Primary hyperparathyroidism unmasking after dienogest-altered estrogen dynamics: implications for calcium homeostasis","volume":"4","author":"Yamashita","year":"2026","journal-title":"JCEM Case Rep"},{"issue":"7","key":"2026101301462567900_luag310-B6","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1530\/EC-20-0221","article-title":"Cinacalcet and primary hyperparathyroidism: systematic review and meta regression","volume":"9","author":"Ng","year":"2020","journal-title":"Endocr Connect"},{"issue":"5","key":"2026101301462567900_luag310-B7","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1007\/s00774-020-01097-y","article-title":"Evocalcet in patients with primary hyperparathyroidism: an open-label, single-arm, multicenter, 52-week, dose-titration phase III study","volume":"38","author":"Takeuchi","year":"2020","journal-title":"J Bone Miner Metab"},{"issue":"3","key":"2026101301462567900_luag310-B8","doi-asserted-by":"crossref","first-page":"180","DOI":"10.2174\/157015907781695982","article-title":"Allosteric modulation of the calcium-sensing receptor","volume":"5","author":"Jensen","year":"2007","journal-title":"Curr Neuropharmacol"},{"issue":"12","key":"2026101301462567900_luag310-B9","doi-asserted-by":"crossref","first-page":"2430","DOI":"10.1681\/ASN.2007121320","article-title":"Cinacalcet reduces the set point of the PTH-calcium curve","volume":"19","author":"Valle","year":"2008","journal-title":"J Am Soc Nephrol"},{"key":"2026101301462567900_luag310-B10","doi-asserted-by":"crossref","DOI":"10.3389\/fendo.2018.00777","article-title":"Parathyroid apoplexy following cinacalcet treatment in primary hyperparathyroidism","volume":"9","author":"Di Dalmazi","year":"2018","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"1","key":"2026101301462567900_luag310-B11","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1186\/s12902-020-0532-7","article-title":"Case report of a cystic parathyroidal adenoma with rapid growth induced by cinacalcet","volume":"20","author":"Werner","year":"2020","journal-title":"BMC Endocr Disord"}],"container-title":["JCEM Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/4\/11\/luag310\/71892089\/luag310.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/4\/11\/luag310\/71892089\/luag310.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T05:46:33Z","timestamp":1791870393000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcemcr\/article\/doi\/10.1210\/jcemcr\/luag310\/8911727"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,25]]},"references-count":11,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2026,9,25]]}},"URL":"https:\/\/doi.org\/10.1210\/jcemcr\/luag310","relation":{},"ISSN":["2755-1520"],"issn-type":[{"value":"2755-1520","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,11]]},"published":{"date-parts":[[2026,9,25]]},"article-number":"luag310"}}