Parathyromatosis is an uncommon cause of hypercalcemia. We describe a case of parathyromatosis and hypercalcemia in a 38-year-old man with a history of end-stage renal disease and subtotal parathyroidectomy in which a previous parathyroid operation was implicated. The results of fine-needle aspiration and histologic examination demonstrated a neck mass consistent with parathyromatosis. We discuss parathyromatosis as a rare cause of recurrent hypercalcemia in patients with end-stage renal disease and in those who have undergone previous parathyroid operations. We also characterize the iatrogenic and the embryologic pathogenetic factors involved.
Histologic examination of the nodules showed well-circumscribed nests of cytologically benign and densely packed parathyroid chief cells with no stromal fat (hematoxylin-eosin, original magnification ×100).
No cytological atypia, mitotic activity, or giant cells were noted in the specimen (hematoxylin-eosin, original magnification ×400).
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