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Spontaneous resolution of primary hyperparathyroidism post-biopsy-related neck haematoma.

QingCi GohChin Voon Tong
Published in: The journal of the Royal College of Physicians of Edinburgh (2023)
Spontaneous or fine-needle aspiration (FNA)-induced remission of primary hyperparathyroidism (PHPT) is an extremely rare phenomenon with variable outcomes. We report a 75-year-old gentleman who initially presented with left ureteric calculi and was found to have PHPT. Imaging studies including ultrasound neck, parathyroid sestamibi scan and computed tomography of thorax, abdomen, and pelvis failed to identify the culprit lesion and he was planned for exploratory parathyroidectomy. Before surgery, he underwent FNA for cytology of a right cold thyroid nodule and it was complicated with large neck haematoma and dysphagia. The cytology of the aspirated fluid was consistent with a benign cyst. One month after the procedure, the serum calcium and phosphate normalised along with the resolution of haematoma. He remained in biochemical remission at 1-year follow-up with the latest ultrasound of neck showing the resolution of a large colloid nodule that was previously seen occupying the right thyroid lobe.
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