case_images: PMC11746029_01
case_images: Summary of the patient's pre-operative examinations. (A, B) neck ultrasonography. Hyperplastic parathyroids are located below the level of the thyroid gland on the right (A) and left (B) sides of the neck (maximum diameter of 2.5 and 3.0 cm, respectively). (C, D) magnetic resonance Imaging. In the opposition phase, T2-weighted magnetic resonance images of the neck show hyperplastic parathyroid glands located under the left thyroid lobe (A) and behind the right thyroid lobe (B), characterized by hyperintensity signal, measuring 2.0 x 1.2 x 3.5 cm and 2.3 x 1.3 x 2.2 cm, respectively (APD x TD x LD). (E, F) parathyroid scintigraphy (99mTc 174 MBq + 99mTc-MIBI 326MBq). Pictures show an area of residual 99mTc-MIBI fixation located near the left thyroid lobe, compatible with a hyperfunctional parathyroid.
case_images: fendo-15-1496386-g001.jpg
case_images: PMC11746029_01_fendo-15-1496386-g001.jpg
case_images: f1
case_images: Diagnostic examinations are reported in  Figure 1 .
case_images: Trend of postoperative ionized calcium levels (mEq/l) (A) and calcium gluconate infusion velocity (ml/l) (B). to acknowledge the contributions of specific colleagues, institutions, or agencies that aided the efforts of the authors.
case_images: fendo-15-1496386-g002.jpg
case_images: PMC11746029_01_fendo-15-1496386-g002.jpg
case_images: f2
case_images: The patient required continuous infusion of calcium gluconate (12.6 mEq in 500 ml of saline solution), with the infusion rate adjusted based on serum calcium levels (Figure 2).