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Peer-reviewedCC BY 4.0Frontiers in Endocrinology

Case Report: Laser thermal ablation for severe primary hyperparathyroidism in a pregnant patient with MEN1 syndrome

  • Mateusz Obal1
  • Marcin Motyka1
  • Grzegorz Sokołowski2
  • Tomasz Piskorz3
  • Hubert Huras4
  • Alicja Hubalewska-Dydejczyk2
4 affiliations
  1. 1Endocrinology, Oncology Endocrinology, Nuclear Medicine and Internal Medicine Clinical Department, University Hospital, Krakow, Poland
  2. 2Chair and Department of Endocrinology, Collegium Medicum, Jagiellonian University, Krakow, Poland
  3. 3Obstetrics and Perinatology Clinical Department, University Hospital, Krakow, Poland
  4. 4Department of Obstetrics and Perinatology, Collegium Medicum, Jagiellonian University, Krakow, Poland
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Abstract

Primary hyperparathyroidism (PHPT) during pregnancy is a rare clinical entity associated with substantial maternal and fetal morbidity, particularly when complicated by severe hypercalcemia. We present the case of a 44-year-old multigravida at 27 + 5 weeks’ gestation who presented with symptomatic, severe hypercalcemia (3.12 mmol/L), and acute kidney injury. Diagnostic evaluation confirmed bilateral parathyroid lesions. Due to high surgical risk and patient refusal of traditional parathyroidectomy, ultrasound-guided laser thermal ablation (LTA) of the dominant right inferior adenoma was performed. The procedure induced a rapid reduction in parathyroid hormone (PTH) concentrations and normalization of serum calcium levels, accompanied by a marked recovery of renal function. Subsequent genetic testing identified a pathogenic MEN1 mutation, confirming multiple endocrine neoplasia type 1. At 39 weeks of gestation, the patient delivered a healthy infant via elective cesarean section, with no evidence of neonatal hypocalcemia. This case demonstrates that LTA may serve as a safe, effective, and minimally invasive alternative for managing severe PHPT in pregnancy when conventional surgery is contraindicated or declined. To our knowledge, this represents the first reported application of LTA in this specific clinical scenario.

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Cite

BibTeXRIS
BibTeX
@article{obal2026case,
  title = {{Case Report: Laser thermal ablation for severe primary hyperparathyroidism in a pregnant patient with MEN1 syndrome}},
  author = {Mateusz Obal and Marcin Motyka and Grzegorz Sokołowski and Tomasz Piskorz and Hubert Huras and Alicja Hubalewska-Dydejczyk},
  journal = {Frontiers in Endocrinology},
  year = {2026},
  month = oct,
  doi = {10.3389/fendo.2026.1964081},
  url = {https://doi.org/10.3389/fendo.2026.1964081},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Case Report: Laser thermal ablation for severe primary hyperparathyroidism in a pregnant patient with MEN1 syndrome
AU  - Mateusz Obal
AU  - Marcin Motyka
AU  - Grzegorz Sokołowski
AU  - Tomasz Piskorz
AU  - Hubert Huras
AU  - Alicja Hubalewska-Dydejczyk
PY  - 2026
DA  - 2026/10/12
JO  - Frontiers in Endocrinology
DO  - 10.3389/fendo.2026.1964081
UR  - https://doi.org/10.3389/fendo.2026.1964081
AB  - Primary hyperparathyroidism (PHPT) during pregnancy is a rare clinical entity associated with substantial maternal and fetal morbidity, particularly when complicated by severe hypercalcemia. We present the case of a 44-year-old multigravida at 27 + 5 weeks’ gestation who presented with symptomatic, severe hypercalcemia (3.12 mmol/L), and acute kidney injury. Diagnostic evaluation confirmed bilateral parathyroid lesions. Due to high surgical risk and patient refusal of traditional parathyroidectomy, ultrasound-guided laser thermal ablation (LTA) of the dominant right inferior adenoma was performed. The procedure induced a rapid reduction in parathyroid hormone (PTH) concentrations and normalization of serum calcium levels, accompanied by a marked recovery of renal function. Subsequent genetic testing identified a pathogenic MEN1 mutation, confirming multiple endocrine neoplasia type 1. At 39 weeks of gestation, the patient delivered a healthy infant via elective cesarean section, with no evidence of neonatal hypocalcemia. This case demonstrates that LTA may serve as a safe, effective, and minimally invasive alternative for managing severe PHPT in pregnancy when conventional surgery is contraindicated or declined. To our knowledge, this represents the first reported application of LTA in this specific clinical scenario.
SN  - 1664-2392
ER  -