Frontiers in Veterinary Science· 2026Q1· Case report
Primary hyperparathyroidism in a cat with synchronous bilateral parathyroid carcinomas: a case report
- 0citations
- Q1SCImago
- 2026year
Short summary
A 14-year-old Russian Blue cat with primary hyperparathyroidism (PHPTH) was diagnosed with synchronous bilateral parathyroid carcinomas, a rare condition, presenting with hypercalcemia and clinical signs. Surgical excision of both parathyroid masses led to normalized serum calcium levels and no recurrence at 161 days post-op.
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Key points
- A 14-year-old cat was diagnosed with primary hyperparathyroidism (PHPTH) due to persistent hypercalcemia and elevated parathyroid hormone.
- Bilateral parathyroid lesions were identified, but preoperative imaging and cytology could not definitively determine malignancy.
- Histopathology confirmed synchronous bilateral low-grade, well-differentiated parathyroid carcinomas with subtle infiltrative growth and capsular penetration.
- Surgical excision of both parathyroid masses resulted in normalized serum calcium levels and no evidence of recurrence or metastasis at 161 days post-operation.
AI-generated from the title and abstract; the full text is not read.
Abstract
Primary hyperparathyroidism (PHPTH) is a rare endocrine disorder in cats, and bilateral parathyroid carcinoma is exceptionally uncommon. A 14-year-old neutered male Russian Blue cat presented with decreased appetite, reduced activity, vomiting, and persistent hypercalcemia. Hypercalcemia was documented by increased ionized calcium (iCa; 1.90 mmol/L) and total calcium (14.3 mg/dL), and an increased intact parathyroid hormone concentration (18.6 pg/mL) supported a diagnosis of PHPTH. Cervical ultrasonography, computed tomography, and fine-needle aspiration cytology identified bilateral parathyroid-associated lesions but could not determine malignancy or the functional contribution of each lesion. During preoperative stabilization with intravenous 0.9% sodium chloride and furosemide, the iCa concentration decreased from 1.90 to 1.47 mmol/L. On the fourth day of hospitalization, complete right thyroid lobectomy with excision of the associated right parathyroid mass and left parathyroidectomy with partial left thyroidectomy were performed. Histopathologic examination supported the diagnosis of synchronous bilateral low-grade, well-differentiated parathyroid carcinomas, with infiltrative growth into adjacent non-neoplastic parathyroid tissue in the left lesion and focal capsular penetration in the right lesion. Postoperative hypocalcemia was managed with intravenous calcium gluconate and oral calcitriol during hospitalization, followed by oral vitamin D supplementation after discharge. Serum iCa normalized by postoperative day 28 and remained within the reference interval thereafter. On postoperative day 161, serum iCa and iPTH concentrations were within their respective reference intervals, and follow-up CT showed no evidence of local recurrence or detectable metastasis. This case highlights that bilateral parathyroid carcinomas may exhibit subtle histopathologic evidence of malignancy that is not predicted by preoperative imaging or cytology, while lesion-specific functional status and anatomical relationships to the thyroid gland may independently influence surgical planning.
The authors' abstract, as published at the source. Frontiers in Veterinary Science, 2026 · DOI ↗
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