Hyperparathyroidism secondary to parathyroid carcinoma

Authors

  • Lourdes Cruz Jesus Interna do lnternato Complementar de Medicina Interna, Serviço de Medicina Interna do Centro Hospitalar de Coimbra
  • Ana Belmira Santos lnterna do lnternato Complementar de Nefrologia, Serviço de Medicina Interna do Centro Hospitalar de Coimbra
  • Deolinda Portelinha Assistente Hospitalar de Medicina Interna, Serviço de Medicina Interna do Centro Hospitalar de Coimbra
  • A. Neves Firmo Assistente Hospitalar Graduado de Cirurgia Geral, Serviço de Medicina Interna do Centro Hospitalar de Coimbra

Keywords:

hypercalcaemia, hyperparathyroi­dism, carcinoma

Abstract

The authors describe a case of parathyroid carcino­ma in a 40 year old patient, who presented with clinical symptoms of six month duration, characterized by generalized bone pain, muscle weakness, polydipsia, polyuria, marked lassitude, and a palpable cervical nodule. Laboratorial results revealed severe hypercalca­emia, raised alkaline phosphatase, renal failure and ex­tremely high levels of intact parathyroid hormone

(PTHi). Radiological imaging revealed the exis­ tence of cystic fibrosing osteitis and parentchimal calcification of renal tissue. Studies of the neck showed a heterogenous structure of the left lobe of the thyroid.

Following surgical excision of the tumour com­plete remission of clinical symptoms, as well as normalization of laboratory, values, were ob­served. Nevertheless, ten months after surgery a new rise in PTHi level, consequent hypercal­caemia, and cervical adenopathy ocurred, re­quiring surgical removal once again. The au­thors present the clinical case as well as thera­peutic strategies.

Downloads

Download data is not yet available.

References

Mundy GR, Cove DH, Fisken R. Primarry Hyperparathiroidism: changes in the pattern of clinicai presentation. Lancet 1980; 1: 1:117-1.320

Mckeown PP, McGarity WC, Sewell CW. Carcinoma of the Para­ thyroid Gland: Is it over diagnosed, A report of three cases. Am J of Surg 1984;147 :292-298.

Holmes EC, Morton DL, Ketcham AS. Parathyroid carcinoma: a collective rewiew. Ann surg 1969; 169:631-640.

Kay S, Hume DM. Carcinoma of the parithyroid gland: how reliable are the clinical and histological features? Arch Pa­thol 1973: 96:316-319.

Anderson BJ, Samaan NA, Vassilopoulou-Sellin R, Ordonez NG, Hickey RC. Parathyroid carcinoma: features and difficulties in diagnosis and management. Surgery 1983; 94: 906-915.~

Wang C, Gaz RD. Natural history of parathyroid carcinoma. Di­agnosis, treatment, and results. Am J of Surg 1985; 149:522- 527.

Scully RE, Mark E;J, et ai. Case records of the Massachusetts, General Hospital. New Engl J Med 1993; 328(14):1031-1035.

Roth SL. Patholohry of the parathyroids in hyperparathyroidism: discussion of recent advances in the anatomy and patholo­gy of the parathyroid glands. Arch Pathol 1962; 73:495-510.

Roth SL. Recent advances in parathyroid gland pathology Am J Med 1971; 50: 612-622.

Rao DS. Primary hyperparathyroidism: changing patterns in presentation and treatment decisions in the eighties. Henry Ford Hosp Med J 1985; 33:194-197.

Numann PJ, Torppa Aj, Hlumetti AE. Neuropsychologic defi­cit associattted with primary hyperparathyroidism. Surgery 1984; 96: 1119-1123.

Heath H, Hodgson SF, Kennedy MA. Primary hiperparathyroi­dism: incidence, morbidity, and potencial economic impact in a community. N Engl J Med 1980; 302:189-193.

Morris RCJr, Sebastian A, McSherry E. Renal acidosis. Kidney Int 1972;1:322-340.

Dauphine RT, Riggs HL, Scholz DA. l:3ack pain and vertebral crush fractures: an unemphasized mode of presentation for primary hyperparathyroidism. Ann Intern Med 1975; 83:365- 367

Genant HK, Baron JM, Straus FH, Paloyan E, .Jowsey J. Osteos­clerosis in primary hyperparathyroidism. Am .J Med 1975;59:104-113.

Scholz DA, Hypertension and Hyperparathyroidism. Arch ln­ tem Med 1977;137:1123-1124.

Kleerekoper M, Rao DS, Frame B. Hypercalciuria, hyperpara­thyroidism, and hypertension. Cardiovasc Med 1978;3:1283- 1298.

Schantz A, Castleman B, Parthyroid carcinoma: a study of 70 cases. Cancer 1973;31:600-605.

Rosai J. Ackerman's surgical pathology, 6th Ed. St. Louis: CV Moshy, 1981:392.

Bukowski RM, Sheeler L, Cunningham J, Esselstyn C. Success­ ful combination chemotherapy for metastatic parathyroid carcinoma. Arch Intern Med 1984; 144:399-400.

Flye MW, Brennam MF. Surgical resection of metastatic para­ thyroid carcinoma. Ann Surg 1981;193:425-435

Saxe AW, Brennan MF. Strategy anel technique of reoperative parathyroide surgery. Surgery 1981: 417-423.

Clark OH, Way LW. Recurrent Ann Surg 1976; 184:391-399.

Barnes B, Cope O: Cancer of the parathyroid glands: Report of 10 cases with endocrine function. JAMA 1961;171:556-559.

Cope O, Nardi GL, Castlsman B. Carcinoma of the parathyroid glands: 4 cases among 143 patientes with hyperparatiroi­dism. Ann Surg 1953;138:661-671.

Additional Files

Published

1998-03-31

How to Cite

1.
Cruz Jesus L, Santos AB, Portelinha D, Neves Firmo A. Hyperparathyroidism secondary to parathyroid carcinoma. RPMI [Internet]. 1998 Mar. 31 [cited 2024 Dec. 18];5(1):32-5. Available from: https://revista.spmi.pt/index.php/rpmi/article/view/2103

Issue

Section

Case Reports

Similar Articles

You may also start an advanced similarity search for this article.

Most read articles by the same author(s)