Primary Hyperparathyroidism from Parathyroid Carcinoma Presenting with Multiple Skeletal Fractures and Brown Cell Tumors

Authors

Keywords:

hypercalcemia, hyperparathyroidism, parathyroid carcinoma

Abstract

We report the case of a 19-year old Filipino woman who presented with hard masses on the left upper arm and leg with multiple fractures on all extremities. Her serum calcium and intact parathyroid hormone (iPTH) levels were elevated, while serum phosphorus was low. Ultrasonography of the neck revealed a left inferior parathyroid mass. Ultrasound-guided fine needle aspiration of the mass revealed findings consistent with parathyroid carcinoma. After hydration and administration of diuretic and bisphosphonate to control the severe hypercalcemia, she subsequently underwent 3½ gland parathyroidectomy with en-bloc left thyroid lobectomy. There was immediate normalization of biochemical indices after surgery. Three months later, the fractures on all extremities were fully resolved.

Downloads

Download data is not yet available.

Author Biography

Jerome Barrera, Zamboanga City Medical Center

Training Officer, Department of Internal Medicine, Zamboanga City Medical Center

Chair, Research Committee Technical Review Board, Zamboanga City Medical Center

Program Head, Zamboanga Doctors' Hospital Wellness Center

Accreditor, Residency Training Program, Philippine College of Physician

 

References

Rahbari R, Kebebew E. Parathyroid tumors. In: DeVita VT Jr, Lawrence TS, Rosenberg SA: Cancer: Principles and Practice of Oncology. 9th ed. Philadelphia, Pa: Lippincott Williams & Wilkins, 2011.

Hundahl SA, Fleming ID, Fremgen AM, Menck HR. Two hundred eighty-six cases of parathyroid carcinoma treated in the U.S. between 1985-1995: A National Cancer Data Base Report. The American College of Surgeons Commission on Cancer and the American Cancer Society. Cancer. 1999;86(3):538-44.

Fraker DL. Update on the management of parathyroid tumors. Curr Opin Oncol. 2000;12 (1):41-8.

Shane E. Clinical review 122: Parathyroid carcinoma. J Clin Endocrinol Metab. 2001;86 (2):485-93.

Shattuck TM, Välimäki S, Obara T, et al. Somatic and germ-line mutations of the HRPT2 gene in sporadic parathyroid carcinoma. N Engl J Med. 2003;349:1722-9.

http://dx.doi.org/10.1056/NEJMoa31237.

Howell VM, Haven CJ, Kahnoski K, et al. HRPT2 mutations are associated with malignancy in sporadic parathyroid tumours. J Med Genet. 2003;40:657-63. http://dx.doi.org/10.1136/jmg.40.9.657.

Cotran RS, Kumar V, Collins T. Robbins Pathologic Basis of Disease. 6th ed. Philadelphia: Saunders, 1999.

Busaidy NL, Jimenez C, Habra MA, et al. Parathyroid carcinoma: A 22-year experience. Head Neck. 2004;26(8):716-26. http://dx.doi.org/10.1002/hed.20049.

Clayman GL, Gonzalez HE, El-Naggar A, Vassilopoulou-Sellin R. Parathyroid carcinoma: Evaluation and interdisciplinary management. Cancer. 2004;100(5):900-5. http://dx.doi.org/10.1002/ cncr.20089.

Wynne AG, van Heerden J, Carney JA, Fitzpatrick LA. Parathyroid carcinoma: Clinical and pathologic features in 43 patients. Medicine (Baltimore). 1992;71(4):197-205.

Nikkilä MT, Saaristo JJ, Koivula TA. Clinical and biochemical features in primary hyperparathyroidism. Surgery. 1989;105(2 Pt 1):148-53.

Vetto JT, Brennan MF, Woodruf J, et al. Parathyroid carcinoma: Diagnosis and clinical history. Surgery.1993;114(5):882-92.

Hoelting T, Weber T, Werner J, Herfarth C. Surgical treatment of parathyroid carcinoma (Review). Oncol Rep. 2001;8(4):931-4. http://dx.doi.org/10.3892/or.8.4.931.

Anderson BJ, Samaan NA, Vassilopoulou-Sellin R, Ordonez NG, Hickey RC. Parathyroid carcinoma: Features and difficulties in diagnosis and management. Surgery. 1983;94(6):906-15.

Sandelin K, Auer G, Bondeson L, Grimelius L, Farnebo LO. Prognostic factors in parathyroid cancer: A review of 95 cases. World J Surg. 1992;16(4):724-31. http://dx.doi.org/10.1007/ BF02067369.

Downloads

Published

2015-11-30

How to Cite

Esplana, C. C., & Barrera, J. (2015). Primary Hyperparathyroidism from Parathyroid Carcinoma Presenting with Multiple Skeletal Fractures and Brown Cell Tumors. Journal of the ASEAN Federation of Endocrine Societies, 30(2), 175. Retrieved from https://asean-endocrinejournal.org/index.php/JAFES/article/view/251

Issue

Vol. 30 No. 2 (2015): November Issue

Section

Case Reports

License

Journal of the ASEAN Federation of Endocrine Societies is licensed under a Creative Commons Attribution-NonCommercial 4.0 International. (full license at this link: http://creativecommons.org/licenses/by-nc/3.0/legalcode).

To obtain permission to translate/reproduce or download articles or use images FOR COMMERCIAL REUSE/BUSINESS PURPOSES from the Journal of the ASEAN Federation of Endocrine Societies, kindly fill in the Permission Request for Use of Copyrighted Material and return as PDF file to jafes@asia.com or jafes.editor@gmail.com.

A written agreement shall be emailed to the requester should permission be granted.

Most read articles by the same author(s)