{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T05:01:07Z","timestamp":1790226067644,"version":"4.1.0"},"reference-count":9,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:p>\n                    A 61-year-old man was admitted to the hospital with fatigue and hypercalcemia, with serum calcium levels as high as 6.16 mmol\/L and parathyroid hormone (PTH) levels &amp;gt;5000 pg\/mL, accompanied by progressively rising serum creatinine levels (150\u2192266 \u03bcmol\/L). A neck ultrasound revealed a small nodule in the left parathyroid region, but\n                    <jats:sup>99m<\/jats:sup>\n                    Tc-MIBI imaging identified a focal area of increased radiotracer uptake within the mediastinum. Following multidisciplinary consultation, a thoracoscopic mediastinal mass resection was performed, and pathology confirmed an ectopic parathyroid adenoma (3.2 \u00d7 2.8 \u00d7 1.5\u00a0cm). Postoperatively, PTH levels dropped sharply to 56.17 pg\/mL, accompanied by severe hypocalcemia (lowest 1.85 mmol\/L) and numbness in the extremities, consistent with the presentation of hungry bone syndrome. Serum calcium levels gradually recovered following intravenous and oral administration of calcium supplements and calcitriol, and renal function also improved significantly. Although all components of this case have been reported individually, the combination of extreme biochemical values, acute kidney injury, and well-documented postoperative course is unusual and instructive. Functional imaging was decisive for localization; postoperatively, hungry bone syndrome should be anticipated and managed proactively. This case demonstrates the full clinical trajectory and offers practical lessons for similar complex presentations.\n                  <\/jats:p>","DOI":"10.3389\/fendo.2026.1890675","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T04:32:03Z","timestamp":1790224323000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: A case of mediastinal parathyroid adenoma leading to hypercalcemic crisis complicated by acute kidney injury and postoperative hungry bone syndrome"],"prefix":"10.3389","volume":"17","author":[{"given":"Yuanzi","family":"Liang","sequence":"first","affiliation":[{"name":"Department of Radiology, Aerospace Center Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junqi","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Aerospace Center Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiqun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Aerospace Center Hospital","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31430-7","article-title":"Hyperparathyroidism","volume":"391","author":"Bilezikian","year":"2018","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","first-page":"8","DOI":"10.21037\/med-2025-1-57","article-title":"Mediastinal parathyroid adenoma: diagnostic and therapeutic challenges","volume":"10","author":"Chan","year":"2026","journal-title":"Mediastinum"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1186\/s13019-025-03605-5","article-title":"Surgical management of ectopic mediastinal parathyroid adenomas: a report of three cases highlighting diagnostic and operative challenges","volume":"20","author":"Eydivandi","year":"2025","journal-title":"J Cardiothorac Surg"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1080\/08941939.2022.2106392","article-title":"Surgical treatment of ectopic mediastinal parathyroid tumors: a 23-year clinical data study in a single center","volume":"35","author":"Liu","year":"2022","journal-title":"J Invest Surg"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14093020","article-title":"Progress in the management of mediastinal ectopic parathyroid adenomas: the role of minimally invasive surgery","volume":"14","author":"Titu","year":"2025","journal-title":"J Clin Med"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2014.09.030","article-title":"Hypercalcemic crisis: a clinical review","volume":"128","author":"Ahmad","year":"2015","journal-title":"Am J Med"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.081018","article-title":"Parathyroid carcinoma","volume":"23","author":"Marcocci","year":"2008","journal-title":"J Bone Miner Res"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-12-0528","article-title":"Hungry bone syndrome: still a challenge in the post-operative management of primary hyperparathyroidism: a systematic review of the literature","volume":"168","author":"Witteveen","year":"2013","journal-title":"Eur J Endocrinol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1186\/s13019-024-02694-y","article-title":"Thoracoscopic treatment of mediastinal ectopic parathyroid adenomas: a Latinamerica experience case series and literature review","volume":"19","author":"Karla Veronica","year":"2024","journal-title":"J Cardiothorac Surg"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1890675\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T04:32:27Z","timestamp":1790224347000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1890675\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,24]]},"references-count":9,"alternative-id":["10.3389\/fendo.2026.1890675"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1890675","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,24]]},"article-number":"1890675"}}