Percutaneous Ethanol Ablation of Parathyroid Adenoma to Acutely Treat Severe Hypercalcemia

Context: Severe hypercalcemia requires immediate treatment and hospital admission for IV hydration and medical therapy.Case description: 59 year old male presented with serum calcium 14.8 mg/dl, PTH 497 pg/ml, he refused hospital admission or IV treatment in the infusion center. Neck ultrasound identified left parathyroid adenoma with hyper vascularity in the inferior part of the gland. Percutaneous ethanol ablation was done in the office and 2 milliliter of dehydrated alcohol was injected in the hyper vascular part of the gland. Calcium decreased to 12 in 14 hours and to normal range in less than 3 days.Conclusion: PEA of parathyroid adenoma is another option of treatment to sever hypercalcemia, the treatment showed decreases in calcium to a safe level as fast as the current standard of care.