Spontaneous remission of primary hyperparathyroidism: a case report and meta-analysis of the literature.
BACKGROUND
In a minority of patients, primary hyperparathyroidism spontaneously remits either by autoinfarction or by hemorrhage into or around the adenoma. We describe a case of autoparathyroidectomy occurring in a 63-year-old man 9 years after three parathyroid glands were removed during a total thyroidectomy. This case is compared with 50 previously reported cases of autoparathyriodectomy, and a meta-analysis is performed.


METHODS
Case report, literature review, and meta-analysis were done using statistical software (SigmaStat 2.0, SPSS, Chicago).


RESULTS
Fifty cases of autoparathyroidectomy were summarized according to the three etiologies. The greatest biochemical aberration was found in the acute intracapsular hemorrhage group, with [Ca(++)] falling from a mean 15.1 mg/dL to 8.9 mg/dL. The average drop in parathyroid hormone was 69% across all groups, comparing favorably to surgical resection.


CONCLUSIONS
Autoparathyroidectomy is a rare but described outcome of unoperated primary hyperparathyroidism that may delay or supplant operative management.
Wootten
Christopher T
CT
Department of Otolaryngology, Vanderbilt University, 1215 21st Avenue South, Nashville, Tennessee 37232, USA. christopher.t.wootten@vanderbilt.edu
Orzeck
Eric A
EA
D000236:Adenoma / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010282:Parathyroid Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D016105:Parathyroidectomy; D011877:Radionuclide Imaging; D012075:Remission, Spontaneous; D013965:Thyroidectomy