# Vitamin D deficiency and surgical cellulose mimicking parathyroid adenoma after initial parathyroidectomy

## TL;DR

A patient's post-surgery mass was mistakenly thought to be a tumor but was actually surgical cellulose, complicated by vitamin D deficiency.

## Contribution

Highlights a rare case where surgical cellulose mimicked a parathyroid adenoma, emphasizing diagnostic challenges in vitamin D deficiency.

## Key findings

- Post-parathyroidectomy cellulose can mimic a parathyroid adenoma on imaging.
- Vitamin D deficiency may complicate the clinical presentation and diagnosis.
- Fine needle aspiration and CT scans helped confirm the cellulose origin of the mass.

## Abstract

Primary hyperparathyroidism is a condition characterized by an excessive production of parathyroid hormone primarily resulting from the presence of an adenoma or hyperplasia of the parathyroid glands.

A 45-year-old woman who had previously experienced high levels of calcium in her blood and abnormally elevated parathyroid hormone levels underwent surgical removal of the left parathyroid gland. Following surgery, she exhibited high levels of parathyroid hormone along with normalized calcium levels and persistent fatigue. Ultrasound imaging showed a hypoechoic mass on the left side, which was initially considered to be a recurrent parathyroid tumor.

A comprehensive assessment, including neck CT scans and fine needle aspiration cytology, revealed that the mass was actually residual surgical cellulose, making diagnosis more challenging due to vitamin D deficiency.

Following parathyroid surgery, surgical cellulose may mimic a parathyroid adenoma.