Parathyroid Adenoma Associated with Granulomatous Inflammation- A Case Report

Parathyroid adenoma is a benign neoplasm derived from the parenchymal cells of a parathyroid gland. Most patients present with unknown aetiology. Inflammatory disorders of the parathyroid gland are poorly defined and necrotising granulomatous inflammation of the parathyroid gland is very rare and its co-existence with a functioning adenoma of the parathyroid is indeed a unique presentation. This is the case of a 47-year-old female who presented with generalised weakness and joint pain with radiological and biochemical evidence of hyperthyroidism. The patient had undergone a nuclear tc99 sestamibi parathyroid scan which was suggestive of parathyroid adenoma and was operated for the same. Routine histopathological examination was suggestive of parathyroid adenoma with chronic granulomatous inflammation. However, diagnostic possibilities of inflammatory aetiologies are numerous and each has presented its characteristics, and theories have always focused on disorders of the parathyroid gland which can occur probably due to autoimmune and non infectious aetiology. Hypercalcaemia can be caused by many causes. However, parathyroid adenoma with coexistent granulomatous inflammation is a rare finding. Sometimes it is not possible to find the exact cause of granulomatous inflammation as in the present case.