B.E., a 58-year-old woman with a history of hypertension, had a partial nephrectomy 4 years ago for renal calculi. During a routine physical examination, her total serum calcium level was 10.8 mg/dL. Her parathyroid hormone level was WNL; she was in no apparent distress, and the remainder of her physical examination and laboratory data were noncontributory.
B.E. underwent exploratory surgery for an enlarged right superior parathyroid gland. The remaining three glands appeared normal. The enlarged gland was excised, and a biopsy was performed on the remaining glands. The pathology report showed an adenoma of the abnormal gland. On her first postoperative day, she complained of perioral numbness and tingling. She had no other symptoms, but her serum calcium was subnormal. She was given one ampule of calcium gluconate. Within 2 days, her calcium level had improved and she was discharged.
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