Intractable Parathyromatosis despite extensive surgical interventions: A case report with literature review.

INTRODUCTION AND IMPORTANCE: Parathyromatosis is a very rare condition where persistent hyperparathyroidism occurs after surgical excision of the parathyroid gland. That is explained by many theories mainly a seeding of parathyroid gland tissue post parathyroidectomy. We report a rare case presentation of Parathyromatosis and the clinical course with the consequences of her condition.

CASE PRESENTATION: a 38 years old female presented first time in 2003 with a parathyroid cyst that underwent excision which was ruptured accidentally and seeding of content happened. As a consequence, she had multiple presentations of recurrent hyperparathyroidism with different locations in the neck region in which parathyroid tissue was found invading muscle, subcutaneous tissue, and surrounding structure, she was managed surgically eight times during 20 years combined with medical management with intermittent remission.

DISCUSSION: Parathyromatosis diagnosis is challenging and requires differentiating it from other gland pathology such as adenoma or carcinoma, management must include meticulous en-block resection to eliminate all parathyroid tissue, recurrence is high which may require multiple surgeries.

CONCLUSION: managing such a rare condition is very challenging in diagnosis and management ranging from medical therapy to Surgery which may reach multiple attempts to control the disease, we also refer to the reason possibly due to multiple theories of getting this condition. Such a long-term disease, it needs surveillance follow-up to prevent the complication and recurrence.