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Clinical Challenge | Pathology

Hypercalcemia in a Young Man QUIZ ONLINE FIRST

Michael Canfarotta, BS1; Poornima Hegde, MD2; Kourosh Parham, MD, PhD3
[+] Author Affiliations
1University of Connecticut School of Medicine, Farmington
2Department of Pathology and Laboratory Medicine, University of Connecticut Health Center, Farmington
3Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of Connecticut Health Center, Farmington
JAMA Otolaryngol Head Neck Surg. Published online April 28, 2016. doi:10.1001/jamaoto.2016.0072
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A man had an elevated serum ionized calcium level; joint, back, and abdominal pain; constipation; fatigue; and depression; he underwent a parathyroid exploration and excision of a soft, ovoid tissue, believed to be a slightly enlarged left inferior parathyroid gland. What is your diagnosis?

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A, Technetium Tc-99m sestamibi scan with sodium iodide I-123 subtraction. Columns 2 to 4 show delayed images at 30 minutes, 1 hour, and 2 hours. B-D, Histopathologic images (hematoxylin-eosin) of thinly encapsulated parathyroid tissue.

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