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    The management of acute parathyroid crisis secondary to parathyroid carcinoma: a case report.

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    Authors
    Rock, Kathy
    Fattah, Nariman
    O'Malley, Diarmuid
    McDermott, Enda
    Affiliation
    Surgical Professorial Unit, Saint Vincent's University Hospital, Dublin 4, Ireland. kathyrock2@hotmail.com.
    Issue Date
    2010
    
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    Citation
    The management of acute parathyroid crisis secondary to parathyroid carcinoma: a case report. 2010, 4 (1):28 J Med Case Reports
    Journal
    Journal of medical case reports
    URI
    http://hdl.handle.net/10147/93873
    DOI
    10.1186/1752-1947-4-28
    PubMed ID
    20181049
    Abstract
    ABSTRACT: INTRODUCTION: Hypercalcaemic hyperparathyroid crisis is a rare but life-threatening complication of primary hyperparathyroidism. Parathyroid carcinoma is a rare malignancy with an incidence of 0.5% to 4% of all reported cases of primary hyperparathyroidism. CASE PRESENTATION: We report the case of a 60-year-old Caucasian man with hypercalcaemic hyperparathyroid crisis associated with parathyroid carcinoma. He presented with a classic hypercalcaemic syndrome and his serum calcium and parathyroid hormone levels were at 4.65 mmol/L and 1743 ng/L, respectively. He initially presented with a two-week history of weakness and lethargy and a one-week history of vomiting, polyuria and polydipsia. An emergency left thyroid lobectomy and left lower parathyroidectomy were performed. There was a prompt decrease in his parathyroid hormone level immediately after surgery. Histology revealed that our patient had a 4-cm parathyroid carcinoma. CONCLUSION: In patients with parathyroid carcinoma, the optimal surgical treatment is en bloc resection with ipsilateral thyroid lobectomy and removal of any enlarged or abnormal lymph nodes. Surgery is the only curative treatment. In our patient, prompt surgical intervention proved successful. At six months the patient is well with no evidence of disease recurrence. This case highlights the importance of considering a hyperparathyroid storm in the context of a parathyroid carcinoma. Parathyroid carcinoma is a rare entity and our knowledge is mainly derived from case reports and retrospective studies. This case report increases awareness of this serious and life-threatening complication. This report also illustrates how prompt and appropriate management provides the best outcome for the patient.
    Language
    en
    ISSN
    1752-1947
    ae974a485f413a2113503eed53cd6c53
    10.1186/1752-1947-4-28
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