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Multiglandular Parathyroid Carcinoma: A Case Report and Brief Review

Prem Sahasranam, MD, Michael T. Tran, MD, Hezla Mohamed, MD, Theodore C. Friedman, MD, PhD
Volume: 100 Issue: 8 August, 2007

Abstract:

A 53-year-old man with no past medical history was admitted with complaints of hematuria, flank and abdominal pain of one week duration. He also complained of an enlarging new neck mass one month before presentation. The laboratory assessment showed a calcium level of 17.3 mg/dL (normal 8.5–10.5 mg/dL), serum albumin 2.9 g/dL (normal 3.0–5.0 g/dL), serum creatinine 3.4 mg/dL (normal 0.5–1.2 mg/dL). A neck ultrasound showed a complicated left neck mass. He was hydrated for one week with improvement in his labs, showing a decrease in serum calcium to 9.3 mg/dL and a serum creatinine of 1.8 mg/dL. He underwent a total thyroidectomy and parathyroidectomy. The pathology showed multiglandular parathyroid carcinoma. It is important for the physician and surgeon dealing with primary hyperparathyroidism to look for parathyroid carcinoma. A better knowledge and understanding of this condition would aid in early diagnosis and possibly increase the survival rate.


Key Points


* Parathyroid adenoma, parathyroid hyperplasia and rarely, parathyroid carcinoma, cause primary hyperparathyroidism.


* Parathyroid carcinoma can occur in familial and sporadic forms.


* Parathyroid hormone secreted by the tumor leads to severe hypercalcemia.


* Hypercalcemia is the cause of morbidity and mortality in these patients.


* Surgery is the treatment of choice for parathyroid carcinoma.

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