{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:02:17Z","timestamp":1791820937797,"version":"4.3.4"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"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. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Primary hyperparathyroidism (PHPT) during pregnancy is rare, with an estimated prevalence of &amp;lt;1% among pregnant women. While often asymptomatic, it may lead to serious maternal complications (nephrolithiasis, pancreatitis, preeclampsia) and adverse fetal outcomes (growth restriction, miscarriage, preterm delivery, stillbirth). Surgical parathyroidectomy in the second trimester remains the gold standard treatment, but may be unfeasible due to gestational age, contraindications, or patient refusal. In such situations, minimally invasive techniques such as microwave ablation (MWA) have emerged as potential alternatives, though their use in pregnancy is extremely rare, with only one case previously reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case<\/jats:title>\n                    <jats:p>We report the case of a 38-year-old woman in her second trimester, with a history of multiple miscarriages and no living children, referred for hypercalcemia discovered on routine screening. Laboratory tests revealed corrected serum calcium of 11.54\u202fmg\/dL (85\u2013105), elevated intact parathyroid hormone (iPTH) at 100.3\u202fpg.\/mL (15\u201365), and marked hypercalciuria. Cervical ultrasound demonstrated a vascularized hypoechoic lesion posterior to the left thyroid lobe, consistent with a parathyroid adenoma, further confirmed by fine-needle aspiration with PTH washout (2075\u202fpg.\/mL). After refusal of surgery, ultrasound-guided MWA was performed under local anesthesia with hydrodissection to protect adjacent structures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Within 1\u202fh, iPTH dropped to 16.8\u202fpg.\/mL and serum calcium normalized to 10.0\u202fmg\/dL, remaining stable throughout pregnancy. Symptoms resolved within days. Obstetric monitoring confirmed healthy fetal development. At 38\u202fweeks, the patient delivered a healthy infant by cesarean section. No maternal or fetal complications occurred.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case represents only the second reported use of MWA for PHPT during pregnancy, demonstrating its feasibility, efficacy, and safety in a highly selected patient. MWA may provide a valuable minimally invasive alternative when surgery is contraindicated or refused, though further evidence is needed to define its role in this unique clinical context.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2025.1688249","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T06:46:41Z","timestamp":1769150801000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Primary hyperparathyroidism in pregnancy successfully treated with microwave ablation: a case report"],"prefix":"10.3389","volume":"12","author":[{"given":"Abderrahim","family":"Bey","sequence":"first","affiliation":[{"name":"Cabinet M\u00e9dical Docteur Bey Abderrahim","place":["Algiers, Algeria"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1111\/j.1365-2265.2008.03495.x","article-title":"Hyperparathyroidism during pregnancy and the effect of rising calcium on pregnancy loss: a call for earlier intervention","volume":"71","author":"Norman","year":"2009","journal-title":"Clin Endocrinol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1097\/00006254-200206000-00022","article-title":"Primary hyperparathyroidism in pregnancy: evidence-based management","volume":"57","author":"Schnatz","year":"2002","journal-title":"Obstet Gynecol Surv"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1080\/08998280.2011.11928719","article-title":"Primary hyperparathyroidism and pregnancy","volume":"24","author":"Som","year":"2011","journal-title":"Proc (Bayl Univ Med Cent)"},{"key":"ref4","first-page":"3394","article-title":"Pregnancy outcome in women with primary hyperparathyroidism","volume":"94","author":"Hirsh","year":"2009","journal-title":"J Clin Endocrinol Metab"},{"key":"ref5","first-page":"949","article-title":"Hyperparathyroidism during pregnancy: maternal and fetal outcomes","volume":"18","author":"Norman","year":"2012","journal-title":"Endocr Pract"},{"key":"ref6","first-page":"e220044","article-title":"Maternal and perinatal outcome of primary hyperparathyroidism in pregnancy: a multicenter study","volume":"11","author":"Paakkonen","year":"2022","journal-title":"Endocr Connect"},{"key":"ref7","first-page":"1020","article-title":"Parathyroid carcinoma during pregnancy","volume":"14","author":"Castillo","year":"2008","journal-title":"Endocr Pract"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1811","DOI":"10.1007\/s00268-010-0569-2","article-title":"Hyperparathyroidism in pregnancy: options for localization and surgical therapy","volume":"34","author":"McMullen","year":"2010","journal-title":"World J Surg"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"3755","DOI":"10.3748\/wjg.v30.i32.3755","article-title":"Primary hyperparathyroidism-induced acute pancreatitis in pregnancy: a systematic review with a diagnostic-treatment algorithm","volume":"30","author":"Augustin","year":"2024","journal-title":"World J Gastroenterol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1080\/08998280.2011.11928719","article-title":"Management of hyperparathyroidism during pregnancy","volume":"24","author":"Som","year":"2011","journal-title":"Proc (Bayl Univ Med Cent)"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1152\/physrev.00027.2015","article-title":"Maternal mineral and bone metabolism during pregnancy, lactation, and post-weaning recovery","volume":"96","author":"Kovacs","year":"2016","journal-title":"Physiol Rev"},{"key":"ref12","first-page":"549","article-title":"Ultrasound-guided microwave ablation for primary hyperparathyroidism: safety and efficacy in a multicenter study of 105 patients","volume":"37","author":"Hu","year":"2020","journal-title":"Int J Hyperth"},{"key":"ref13","first-page":"245","article-title":"Ultrasound-guided percutaneous microwave ablation of parathyroid adenoma: preliminary results in 20 patients","volume":"42","author":"Liu","year":"2019","journal-title":"Cardiovasc Intervent Radiol"},{"key":"ref14","first-page":"1","article-title":"Radiofrequency ablation versus parathyroidectomy for primary hyperparathyroidism: a systematic review and meta-analysis","volume":"36","author":"Lim","year":"2021","journal-title":"Endocrinol Metab (Seoul)"},{"key":"ref15","first-page":"236","article-title":"Microwave ablation of parathyroid adenoma in pregnancy: a case report","volume":"50","author":"Wei","year":"2022","journal-title":"J Clin Ultrasound"},{"key":"ref16","first-page":"6","article-title":"Calcitonin in pregnancy and lactation","volume":"37","author":"Kovacs","year":"2010","journal-title":"Endocrine"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"280","DOI":"10.14310\/horm.2002.1319","article-title":"The use of bisphosphonates in women prior to or during pregnancy and lactation","volume":"10","author":"Stathopoulos","year":"2011","journal-title":"Hormones (Athens)"},{"key":"ref18","first-page":"1452","article-title":"Skeletal anomalies in neonates exposed to bisphosphonates in utero","volume":"192","author":"Green","year":"2005","journal-title":"Am J Obstet Gynecol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2011\/520516","article-title":"Primary hyperparathyroidism in pregnancy\u2014a case series and review","volume":"2011","author":"Malekar-Raikar","year":"2011","journal-title":"Arch Gynecol Obstet"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"832","DOI":"10.1210\/edrv.18.6.0319","article-title":"Maternal-fetal calcium and bone metabolism during pregnancy, puerperium, and lactation","volume":"18","author":"Kovacs","year":"1997","journal-title":"Endocr Rev"},{"key":"ref21","first-page":"476","article-title":"Primary hyperparathyroidism in pregnancy treated with cinacalcet","volume":"14","author":"Patel","year":"2008","journal-title":"Endocr Pract"},{"key":"ref22","first-page":"3394","article-title":"Cinacalcet in pregnancy: a novel treatment for primary hyperparathyroidism?","volume":"94","author":"Horjus","year":"2009","journal-title":"J Clin Endocrinol Metab"},{"key":"ref23","first-page":"244","article-title":"High-intensity focused ultrasound versus radiofrequency ablation for benign thyroid nodules: a multicenter study","volume":"36","author":"Zhou","year":"2019","journal-title":"Int J Hyperth"},{"key":"ref24","first-page":"269","article-title":"Efficacy and safety of thermal ablation for benign thyroid nodules: a prospective multicenter study","volume":"22","author":"Lim","year":"2021","journal-title":"Korean J Radiol"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1688249\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T06:46:46Z","timestamp":1769150806000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1688249\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,23]]},"references-count":24,"alternative-id":["10.3389\/fmed.2025.1688249"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1688249","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,23]]},"article-number":"1688249"}}