Case Scenario: A young man in his 20s was presented to the clinic with routine laboratory test findings depicting an elevated serum calcium level to 14.1 mg/dL (Average range 8.6 to 10.2 mg/dL). His physical examination results were normal and he denied abdominal pain, dysuria, anxiety, and constipation. He did not have any palpable thyroid nodules or calcium lymphadenopathy. Considering the elevated calcium levels, the parathyroid hormone (PTH) level was measured and was found to be 1377 pg/mL (Normal range 10 to 65 pg/mL).
Owing to the extremely high levels of parathyroid hormones, the patient was recommended for a detailed diagnostic workup. Diagnostic workup: Technetium Tc 99m sestamibi single-photon emission computed tomography (SPECT/CT) demonstrated a 2.2 cm lesion in the right parathyroid gland (fig. A). Plain CT scan showed lytic bone lesions of the mandibular ramus, left…
