A rare case of giant atypical parathyroid tumor presenting as a parathyroid adenoma – discussion of intraoperative challenges

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Abstract Atypical parathyroid tumors are variants of parathyroid adenomas that may present with features of parathyroid carcinoma due to their size, biochemical profile, and atypical features that are typically associated with carcinomas. We report a case of a 75-year-old female presenting with chest pain, hypercalcemia, and severely elevated parathyroid hormone level. Intraoperatively, a 40-g gland was found displacing adjacent structures, raising concern for malignancy. The parathyroid lesion was determined to be an atypical parathyroid tumor. This case highlights the diagnostic challenge in distinguishing atypical parathyroid tumors and highlights the importance of advanced imaging in surgical planning and management of atypical presentations of primary hyperparathyroidism.

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