scholarly journals Severe Hypercalcemia Associated with Hepatocellular Carcinoma Secreting Intact Parathyroid Hormone: A Case Report

2011 ◽  
Vol 50 (4) ◽  
pp. 329-333 ◽  
Author(s):  
Yoko Abe ◽  
Hiroaki Makiyama ◽  
Yomo Fujita ◽  
Yasuhiro Tachibana ◽  
Go Kamada ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Case Report ◽  
Parathyroid Hormone ◽  
Intact Parathyroid Hormone ◽  
Severe Hypercalcemia

Nonfunctional parathyroid cancer − a case report

2021 ◽  
Vol 100 (3) ◽  
Keyword(s):  
Case Report ◽  
Parathyroid Hormone ◽  
Radical Surgery ◽  
Histopathological Examination ◽  
Treatment Protocol ◽  
Normal Serum ◽  
Parathyroid Cancer ◽  
En Bloc ◽  
Mortality And Morbidity ◽  
Severe Hypercalcemia

Introduction: Parathyroid cancer is a rare endocrine malignancy. These tumors are typically functional, causing severe hypercalcemia due to primary hyperparathyroidism. Nonfunctional parathyroid cancer with normal serum calcium and parathyroid hormone levels is extremely rare. The disease is usually indolent but progressive with a tendency to metastasize. It is very difficult to diagnose this malignancy. The definitive diagnosis is made by histopathological examination. Radical surgery with ipsilateral lobectomy and en bloc neck dissection is considered to be the most appropriate therapeutic approach. There is no evidence of efficiency of adjuvant cancer therapy and its indication has not been defined. Disease recurrence is common. Case report: We report the case of a 26-year-old female patient who underwent left hemithyroidectomy for growth progression of a hypoechoic lesion behind the left thyroid lobe detected by ultrasonography. Preoperative cytology and imaging assessments were not suspicious for malignancy. Serum parathyroid hormone and calcium levels were normal. The diagnosis of nonfunctional parathyroid carcinoma was determined based on histopathological examination. No further surgery or adjuvant therapy was indicated. No signs of recurrence or generalization have been observed at 36 months after the surgery. Conclusion: Nonfunctional parathyroid cancer is extremely rare. In many cases, the diagnosis is made in advanced stages of the disease. No formal classification or treatment protocol has been established so far. A new staging system has been proposed in the 8th edition of AJCC/UICC. Early detection, radical surgery and close follow-up are crucial aspects to affect the mortality and morbidity of patients with this type of malignancy.

scholarly journals Severe hypercalcemia caused by parathyroid hormone in a rectal cancer metastasis: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Vegard Heimly Brun ◽  
Erik Knutsen ◽  
Helge Stenvold ◽  
Hanne Halvorsen
Keyword(s):  
Parathyroid Hormone ◽  
Bone Metastasis ◽  
Cancer Metastasis ◽  
Hormone Secretion ◽  
Rectal Adenocarcinoma ◽  
Intact Parathyroid Hormone ◽  
First Case ◽  
Severe Hypercalcemia ◽  
Colorectal Origin ◽  
Proper Diagnosis

Abstract Background Hypercalcemia of malignancy is relatively common in several cancers. However, in colorectal cancer, paraneoplastic phenomena that cause hypercalcemia is uncommon. In the few cases that are reported, secretion of parathyroid hormone-related peptide mediates the effect. We describe the first case of severe hypercalcemia mediated by intact parathyroid hormone secretion from a bone metastasis of colorectal origin. This was a diagnostic and therapeutic challenge. Case presentation A 68-year-old male treated for rectal adenocarcinoma 10 years earlier developed a bone metastasis. After initial treatment of the metastasis with surgery and irradiation, he developed a relapse with severe hypercalcemia and corresponding elevated parathyroid hormone levels. The workup showed no signs of parathyroid adenomas, but the metastasis produced intact parathyroid hormone. The hypercalcemia was successfully treated by irradiation and osteoclast inhibitor, and the patient received chemotherapy. Survival was 24 months from the onset of hypercalcemia. Conclusions Proper diagnosis of the uncommon endocrine disturbance allowed targeted therapy and avoidance of neck exploration for wrongly suspecting primary hyperparathyroidism. Intact parathyroid hormone should be measured in cases of malignant hypercalcemia.

scholarly journals Severe Hypercalcemia as an Initial Presenting Manifestation of Hepatocellular Carcinoma

2002 ◽  
Vol 16 (9) ◽  
pp. 607-609 ◽  
Author(s):  
Michel William Ghobrial ◽  
John George ◽  
Sunitha Mannam ◽  
Samia R Henien
Keyword(s):  
Hepatocellular Carcinoma ◽  
Weight Loss ◽  
Parathyroid Hormone ◽  
Hepatic Encephalopathy ◽  
White Woman ◽  
Hormone Level ◽  
Metastatic Bone Disease ◽  
Parathyroid Hormone Level ◽  
Severe Hypercalcemia ◽  
Parathyroid Hormone Related Peptide

An 80-year-old white woman who presented with fatigue, weakness, weight loss, constipation and polydipsia is reported. The patient was given a diagnosis of severe hypercalcemia and was subsequently found to have clinical, roentgenographic and pathological evidence of hepatocellular carcinoma. Further studies revealed a low parathyroid hormone level, excluding the possibility of primary hyperparathyroidism, and a negative bone survey, precluding metastatic bone disease. The patient’s hypercalcemia was believed to emanate from the humoral secretion of a parathyroid hormone-related peptide, which was found to be elevated, and was abated with conservative management while her cancer was being treated with chemotherapy. The details of this rarely documented presentation, which can easily be mistaken for hepatic encephalopathy, are provided.

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