Abstract #830: Rare Case of Severe Hypercalcemia: Gauchers Disease

Objective: To present a rare case of parathyromatosis. Methods: We present the clinical, laboratory, and imaging findings, along with a review of the literature. Results: A 33-year-old man with a history of right upper parathyroid adenoma removal 5 years prior due to hyperparathyroidism was admitted for severe hypercalcemia (15.6 mg/dL; normal, 8.5 to 10.5 mg/dL) with elevated plasma parathyroid hormone (PTH) (882 pg/mL; normal, 15 to 65 pg/mL). Ultrasound, computed tomography (CT), sestamibi, and positron emission tomography scans were unremarkable; however, a four-dimensional CT (4DCT) of the neck showed an area of increased signal enhancement and hypervascularity without discrete nodule in the posterior right thyroid region. The patient underwent parathyroid surgical exploration with right hemithyroidectomy and compartment neck dissection to remove the affected tissue. PTH levels dropped to 208 pg/mL postoperatively; calcium decreased but remained elevated at 12.7 mg/dL. Pathology revealed the presence of several small nodular foci of atypical hyperplastic parathyroid tissue in the right thyroid and soft tissue in the left central neck compartment consistent with parathyromatosis. Conclusion: This case report represents the first-time use of 4DCT to localize parathyromatosis. Parathyromatosis is a rare but problematic cause of recurrent hyperparathyroidism. Ultrasound and 4DCT may represent the best imaging modalities for identification and perioperative management to remove all affected tissue without reseeding.

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A rare case of hypercalcemia-induced pancreatitis in a first trimester pregnant woman

Endocrinology Diabetes and Metabolism Case Reports ◽

10.1530/edm-17-0175 ◽

2018 ◽

Vol 2018 ◽

Cited By ~ 1

Author(s):

Carine Ghassan Richa ◽

Khadija Jamal Saad ◽

Ali Khaled Chaaban ◽

Mohamad Souheil El Rawas

Keyword(s):

Acute Pancreatitis ◽

Pregnant Woman ◽

Primary Hyperparathyroidism ◽

Rare Case ◽

First Trimester ◽

List Type ◽

Second Trimester ◽

Adequate Treatment ◽

Severe Hypercalcemia ◽

First Trimester Of Pregnancy

Summary The objective of the study is to report a case of acute pancreatitis secondary to hypercalcemia induced by primary hyperparathyroidism in a pregnant woman at the end of the first trimester. The case included a 32-year-old woman who was diagnosed with acute pancreatitis and severe hypercalcemia refractory to many regimens of medical therapy in the first trimester of pregnancy. She was successfully treated with parathyroidectomy in the early second trimester with complete resolution of hypercalcemia and pancreatitis. Neonatal course was unremarkable. To our best knowledge, this is a rare case when primary hyperparathyroidism and its complications are diagnosed in the first trimester of pregnancy. In conclusion, primary hyperparathyroidism is a rare life-threatening condition to the fetus and mother especially when associated with complications such as pancreatitis. Early therapeutic intervention is important to reduce the morbidity and mortality. Parathyroidectomy performed in the second trimester can be the only solution. Learning points: Learning how to make diagnosis of primary hyperparathyroidism in a woman during the first trimester of pregnancy. Understanding the complications of hypercalcemia and be aware of the high mortality and sequelae in both fetus and mother. Providing the adequate treatment in such complicated cases with coordinated care between endocrinologists and obstetricians to ensure optimal outcomes.

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A rare case of tuberculosis-induced hypercalcemia

Biochemia Medica ◽

10.11613/bm.2020.030801 ◽

2020 ◽

Vol 30 (3) ◽

pp. 471-474

Author(s):

Loris Wauthier ◽

Xavier Theunssens ◽

Patrick Durez ◽

Catherine Fillée ◽

Diane Maisin ◽

...

Keyword(s):

Biochemical Parameters ◽

Rare Case ◽

Disease Modifying Antirheumatic Drugs ◽

Antirheumatic Drugs ◽

Atypical Case ◽

Severe Hypercalcemia ◽

Laboratory Investigations ◽

Disease Modifying ◽

25 Oh Vitamin D

Laboratory investigations of hypercalcemia involve testing of various biochemical parameters such as parathyroid hormone (PTH), 25-(OH) Vitamin D (25-(OH) VitD), 1,25-(OH)2 Vitamin D3 (calcitriol) and PTH related peptide (PTHrp). We herein present an atypical case of severe hypercalcemia in a patient with rheumatoid arthritis who has been treated for years by various biological disease-modifying antirheumatic drugs (DMARDs) and suddenly presented with general state alteration, oedema and ulceration of her right ankle. We illustrate how tuberculosis (TB) can cause high calcitriol concentration and subsequently lead to potentially severe hypercalcemia. Moreover, we highlight the importance of TB testing and follow-up in patients treated with biological DMARDs.

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S2140 A Rare Case of Undifferentiated Neuroendocrine Esophageal Carcinoma With Severe Hypercalcemia

The American Journal of Gastroenterology ◽

10.14309/01.ajg.0000782092.16323.4a ◽

2021 ◽

Vol 116 (1) ◽

pp. S920-S920

Author(s):

Brittney Shupp ◽

Nishit Patel ◽

Anthony Cianciolo ◽

Hammad Liaquat ◽

Lisa Stoll ◽

...

Keyword(s):

Esophageal Carcinoma ◽

Rare Case ◽

Severe Hypercalcemia

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Hypercalcemia of malignancy in metastatic adenocarcinoma of left lower eyelid - A report of a rare case

IP International Journal of Ocular Oncology and Oculoplasty ◽

10.18231/j.ijooo.2021.042 ◽

2021 ◽

Vol 7 (2) ◽

pp. 210-212

Author(s):

Divya BM ◽

Shylashree ◽

Muthukumar Mani

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Paraneoplastic Syndrome ◽

Rare Case ◽

Lower Eyelid ◽

Treatment Modalities ◽

Metastatic Adenocarcinoma ◽

Eyelid Skin ◽

Severe Hypercalcemia ◽

Time Of Presentation

Adenocarcinoma of eyelid is a rare disease with an incidence of 1 to 5.5% and is considered to be the most common eyelid malignancy following basal cell and squamous cell carcinoma. The symptoms usually present as swelling, thickening, change in appearance of the eyelid skin and ulceration. Various treatment modalities include surgery, radiation or chemotherapy relying upon the stage of tumor at the time of presentation. However, metastasis of adenocarcinoma of the eyelid to other organs is quite rare. We are presenting a case of a 35 year old male who initially presented with complaints of watering in the left eye and in due course, was diagnosed with adenocarcinoma of eyelid which was being treated and eventually progressed to lung and skeletal tissues. This gentleman also had severe Hypercalcemia which was secondary to paraneoplastic syndrome.

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A Rare Case of Severe Hypercalcemia Secondary to Atypical Parathyroid Cystic Adenoma with Negative Sestamibi Scan

Cureus ◽

10.7759/cureus.6830 ◽

2020 ◽

Author(s):

Elio P Monsour ◽

Faysal Rifai ◽

Jay Chacko ◽

Alan Hamza ◽

Khalid Abusaada

Keyword(s):

Rare Case ◽

Severe Hypercalcemia ◽

Sestamibi Scan ◽

Cystic Adenoma

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Identification of Pulmonary Deposits from a Sandpaper Worker: A Study by Electron Microscopy and X-Ray Microanalysis

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100053061 ◽

1982 ◽

Vol 40 ◽

pp. 52-53

Author(s):

S. K. Peng ◽

M.A. Egy ◽

J. K. Singh ◽

M.B. Bishop

Keyword(s):

Electron Microscopy ◽

Environmental Pollution ◽

Rare Case ◽

Interstitial Fibrosis ◽

X Ray ◽

Documented Case ◽

Etiologic Agents ◽

Pulmonary Interstitial Fibrosis ◽

Gold Miners ◽

Pulmonary Changes

Electron microscopy and energy dispersive x-ray microanalysis (EDXA) are found to be very useful tools for identification of etiologic agents in pneumoconiosis or interstitial pulmonary disorders. Pulmonary interstitial fibrosis and granulomatosis are frequently associated with occupational and environmental pollution. Numerous reports of pneumoconiosis in various occupations such as coal and gold miners are presented in the literature. However, there is no known documented case of pulmonary changes in workers in the sandpaper industry. This study reports a rare case of pulmonary granulomatosis containing deposits from abrasives of sandpaper diagnosed by using EDXA.

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