A Young Man with a Palpable Parathyroid Tumor Presented by Renal Colic

Objective(s):  Primary hyperparathyroidism (PH) is characterized by a high level of blood PTH and calcium.  Case:  A 23-year-old male patient with no previous history of any chronic disease was referred to the urology polyclinic of the hospital due to renal colic. On the direct urinary system chart and in the urinary system ultrasonography, left ureter calculi and grade-2 hydronephrosis were detected in the left kidney. The patient's serum calcium and ionized parathyroid tests were determined to be high and he was consulted to an internist with a prediagnosis of primary hyperparathyroidism. Thyroid / Parathyroid Ultrasonography showed a 12 * 13 * 23-millimeter size, well-defined hypoechoic, slightly heterogeneous solid lesion in the left parathyroid root. Parathyroid scintigraphy sestamibi technetium-99 detected a parathyroid adenoma/hyperplasia in the posterior vicinity of the middle part of the left lobe of the thyroid.  Discussion:  In a young patient, a neck mass usually originates from a congenital disease or due to acute infection. Parathyroid tumors are rare causes of neck masses at young ages.  However, physicians should pay attention to additional findings associated with conditions that may be more serious than the presenting symptoms. In this case, it was a parathyroid tumor diagnosed by careful physical examination of a patient with renal colic. Hastaligi olmayan 23 yasindaki erkek hasta renal kolik nedeniyle hastanenin uroloji poliklinigine basvurdu. Hastada serum kalsiyum ve iyonize parathormon sonuclari yuksekti ve hasta bu sonuclarla primer hiperparatiroidizm on tanisi ile ic hastaliklari uzmanina konsulte edildi. Hastanin Tiroid / Paratiroid Ultrasonografi incelemesinde: sol paratiroid kokunde 12 * 13 * 23 milimetre boyutlarinda, iyi tanimlanmis, hipoekoik, hafif heterojen solid lezyona rastlandi. Paratiroid sintigrafi sestamibi teknisyum-99 incelemesinde tiroidin sol lobu orta kisim arka komsulugunda bir paratiroid adenomu/hiperplazisi tespit edildi. Tartisma: Aile hekimleri gunluk pratiklerine boyun kitleleri ile siklikla karsilasirlar. Genc eriskinlerde boyun kitlelerinin en sik nedenleri konjenital hastaliklar veya enfeksiyonlardir. Paratiroid patolojileri boyun kitleleri genc yasta nadirdir. Sonuc: Genc bir hastada, boyun kitlesi bir konjenital hastalik veya akut bir enfeksiyona baglidir. Bununla beraber, hekimler hastanin mevcut semptomlarindan cok daha ciddi durumlarin isareti olan bulgulara dikkat etmelidir. Bu vakada renal kolik sikayeti ile basvuran bir hastada dikkatli bir muayene ile ortaya konulan bir paratiroid adenomu sunulmustur.