Non-secreting atypical parathyroid adenoma

Parathyroid tumors can be divided in adenomas and carcinomas, usually detec ted by hypercalcemia. We report a case of parathyroid adenoma in a young ma n, who complained of a pressure in the left neck region. Physical examinati on revealed a firm mass in the neck, without lymphnodes. Although Ca (9.7 m g/dl), phosphorus (3.3 mg/dl) and intact-PTH (49 pg/ml) were normal, imagin g techniques (computed tomography scan and sestamibi substraction scan) sug gested that the mass could arise from the parathyroid gland. Histology and immune staining for chromogranin and parathyroid hormone confirmed the para thyroid nature of the mass. Histological criteria defined the lesion as an atypical parathyroid adenoma. We review the pathology, diagnosis and treatm ent of parathyroid adenomas in its non-secreting atypical form. (C)2001, Ed itrice Kurtis.