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Giant parathyroid adenoma and challenges with preoperative differentiation from malignancy
  1. Grace Wong1,
  2. Andrew Ghabbour2 and
  3. Farzad Borumandi3
  1. 1Department of Oral and Maxillofacial Surgery, University Hospitals Sussex NHS Foundation Trust, St Richards Hospital, Chichester, UK
  2. 2Department of Diabetes and Endocrinology, University Hospitals Sussex NHS Foundation Trust, Worthing Hospital, Worthing, UK
  3. 3Department of Oral and Maxillofacial Surgery, University Hospitals Sussex NHS Foundation Trust, St Richards Hospital, Chichester and Worthing Hospital, Worthing, UK
  1. Correspondence to Farzad Borumandi; farzad.borumandi{at}


Giant parathyroid adenomas are rare and underreported benign tumours of parathyroid gland. Preoperative differentiation between giant parathyroid adenoma (GPA) and parathyroid carcinoma can be challenging, as they both may present as a large parathyroid tumour with hyperparathyroidism. Very few GPAs had been described in the literature, with only 60 cases including our present case. We report a case of GPA and the preoperative diagnostic challenges we faced in differential diagnosis of a potential parathyroid malignancy. As a parathyroid malignancy could not be excluded preoperatively the parathyroid tumour was excised en bloc with surrounding thyroid lobe. The histology was contributory to exclude parathyroid malignancy confirming a benign GPA.

  • calcium and bone
  • endocrine cancer
  • head and neck surgery

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  • Contributors FB proposed the design of case report. GW conducted a literature review and composed the initial draft. GW, FB and AG interpreted published evidence in the literature drafted and approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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