Sclerochoroidal Calcification in a Patient With Chronic Hypercalcemia From Undiagnosed Parathyroid Adenoma

In Brief Purpose: To describe a case of sclerochoroidal calcification in a patient with hypercalcemia from undiagnosed parathyroid adenoma. Methods: A 66-year-old white woman was found to have asymptomatic bilateral yellow choroidal tumors characteristic of sclerochoroidal calcification. The calcified tumors were echogenic on ultrasonography. Results: Systemic evaluation disclosed hypercalcemia, and there was no abnormality of the parathyroid glands with hormone levels or nuclear medicine scans. After 4 years, the hypercalcemia persisted, prompting surgical exploration of the parathyroid glands that revealed an adenoma. After resection of the glands, the serum calcium reverted to normal. Discussion: Sclerochoroidal calcification can be associated with systemic hypercalcemia. A search for the cause is warranted, and in this case, a subclinical adenoma was the source of the hypercalcemia. Sclerochoroidal calcification is uncommon and manifests with yellow calcified fundus lesions. It has been associated with hypercalcemia, hypomagnesemia, and hyperparathyroidism. The authors report a patient with sclerochoroidal calcification and hypercalcemia with negative repeated evaluation for parathyroid adenoma until it was discovered during parathyroidectomy.