Primary hyperparathyroidism resolution via auto-infarction discovered intraoperatively

Primary hyperparathyroidism is a condition frequently attributed to the excessive secretion of parathyroid hormone (PTH), often stemming from adenoma, hyperplasia, or carcinoma. While the conventional approach to addressing this condition involves surgical intervention, there exist rare instances where spontaneous resolution occurs, typically because of auto-infarction or necrosis of the parathyroid adenoma. In this report, we present the case of a 64-year-old male with hypercalcemia, referred for surgical intervention. Preoperative imaging unveiled a nodular lesion, and intraoperatively, an acutely infarcted adenoma was discovered. Microscopic examination confirmed parathyroid necrosis. Similar cases documented in the medical literature shed light on the potential for non-surgical management options. Factors such as cinacalcet treatment and hypocalcemia-inducing medications have been explored, suggesting alternative approaches to address this condition. Furthermore, cases of spontaneous remission highlight the paramount importance of long-term follow-up in managing primary hyperparathyroidism, ensuring comprehensive and individualized patient care. The awareness of these infrequent occurrences significantly contributes to well-informed decision-making within the medical community.