Giant Parathyroid Adenoma with Urolithiasis and Pancreatitis

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BSTRACT

Primary hyperparathyroidism (PHPT) is a common endocrine disorder, most frequently caused by a solitary parathyroid adenoma. Giant parathyroid adenomas is defined as those exceeding 3.5 g in weight or 3 cm in size, are rare, and tend to present with more severe hypercalcemia and related complications. We report the case of a 47-year-old man who presented with a 1-year history of intermittent abdominal pain, headache, back pain, irritability, and past episodes of acute pancreatitis and urolithiasis. Laboratory investigations revealed marked hypercalcemia and elevated intact parathyroid hormone (iPTH) levels. Imaging localized a solitary parathyroid lesion, and surgical excision was performed. Histopathological examination confirmed a giant parathyroid adenoma. Postoperatively, calcium and PTH levels normalized, and the patient’s symptoms improved significantly. This case highlights a rare presentation of a giant, functional parathyroid adenoma associated with both pancreatitis and urolithiasis, emphasizing the importance of early recognition, biochemical evaluation, and coordinated surgical management for favorable outcomes.