Sarcoid granulomas in the parathyroid gland — a case of dual pathology: hypercalcaemia due to a parathyroid adenoma and coexistent sarcoidosis with granulomas located within the parathyroid adenoma and thyroid gland

Anjali Balasanthiran; Belinda Sandler; Kwamena Amonoo-Kuofi; Rajiv Swamy; Sunil Kaniyur; Felicity Kaplan

doi:10.1507/endocrj.K10E-028

ORIGINALS

Sarcoid granulomas in the parathyroid gland — a case of dual pathology: hypercalcaemia due to a parathyroid adenoma and coexistent sarcoidosis with granulomas located within the parathyroid adenoma and thyroid gland

Anjali Balasanthiran, Belinda Sandler, Kwamena Amonoo-Kuofi, Rajiv Swamy, Sunil Kaniyur, Felicity Kaplan

Author information

Keywords: Hypercalcaemia, Sarcoidosis, Hyperparathyroidism, Adenoma, Co-existent

JOURNAL FREE ACCESS

2010 Volume 57 Issue 7 Pages 603-607

DOI https://doi.org/10.1507/endocrj.K10E-028

View "Advance Publication" version (June 15, 2010).

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Abstract

We present a highly unusual and interesting case of coexistent hyperparathyroidism and sarcoidosis leading to hypercalcaemia. A 70 year old female presented with weight loss, constipation and dehydration. Investigations revealed marked hypercalcaemia with a non-suppressed PTH. In view of the degree of hypercalcaemia as well as the unintentional weight loss, investigations for malignancy were conducted -these were negative. Parathyroid imaging was then requested and an adenoma was identified. Surprisingly, surgery revealed the coexistence of a parathyroid adenoma with the unexpected finding of sarcoid granulomas within the parathyroid and thyroid glands. To our knowledge, this is the first such case reported. Further imaging confirmed pulmonary sarcoidosis and a serum ACE was elevated. Serum calcium levels did not respond to parathyroidectomy but eventually fell with steroid therapy.

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