Hypercalcemia resistant to cinacalcet caused by a mediastinal hyperplastic parathyroid gland in a renal transplant patient

Background Renal hyperparathyroidism is a common complication in patients with chronic kidney disease. Cinacalcet, a kind of calcimimetic, has been reported to be an effective and safe treatment option in renal transplant patients with hyperparathyroidism. However, some patients require parathyroidectomy due to resistance to cinacalcet treatment. It is uncertain when we should give up treatment with cinacalcet and perform parathyroidectomy for persistent hyperparathyroidism.