Parathyroid Adenoma with Unusual Clinical Features

Primary hyperparathyroidism is an uncommon disease with an incidence of 21 cases per 100,000 per year (approximately).1 Symptoms produced by hyperplasia of the parathyroid are classified into three categories: a) those due to skeletal changes, b) due to urinary changes c) due to hypercalcemia itself.2 They may also be due to the mechanical effect of the tumour such as dysphagia or a feeling of fullness in the neck.3 While symptoms due to pressure per se are rare, it is possible for the tumour to be located such that constant irritation of the recurrent laryngeal nerve may set up local triggers, which when stimulated produce several episodes of coughing and sneezing followed by weakness and at times, syncopal episodes.