Case report: lady with bone pains for 5 years-parathyroid carcinoma.
BMC Res Notes
; 11(1): 617, 2018 Aug 29.
Article
en En
| MEDLINE
| ID: mdl-30157930
ABSTRACT
BACKGROUND:
Parathyroid cancer is a rare cause of primary hyperparathyroidism. It presents a diagnostic and therapeutic challenge that may not be recognized preoperatively, and is often not conclusively identified during the operation. We present the case of a lady with backache and hypercalcemia, but with inadequate work-up for her condition for several years. CASE PRESENTATION A middle aged lady of Asian descent presented with backache. Initial work up revealed mild hypercalcemia, negative work up for multiple myeloma, negative sestamibi scan for parathyroid pathology. A phenomenally elevated parathormone (PTH) level-2105 pg/mL (16-87 pg/mL), and rising serum calcium, 15.1 mg/dL, (8.6-10.5 mg/dL), ordered years later prompted a repeat sestamibi scan and ultrasonography of neck. Based on these investigations, a diagnosis of primary hyperparathyroidism, with high suspicion of parathyroid cancer was made. The patient underwent surgical tumour resection, with subsequent histopathological confirmation of diagnosis.CONCLUSION:
In the setting of hypercalcemia, PTH level assessment is a must. This helps to differentiate between the parathyroid dependant and independent causes of high serum calcium, thereby encouraging a comprehensive pathway to the work up of the cause of hypercalcemia. The parathyroid cancer is a very rare cause of hypercalcemia, which needs to be considered in the differentials of primary hyperparathyroidism, particularly in the setting of high PTH levels.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Dolor
/
Neoplasias de las Paratiroides
/
Hiperparatiroidismo Primario
Tipo de estudio:
Prognostic_studies
Límite:
Female
/
Humans
/
Middle aged
País/Región como asunto:
Asia
Idioma:
En
Revista:
BMC Res Notes
Año:
2018
Tipo del documento:
Article
País de afiliación:
Pakistán