A CASE OF PARATHYROID ADENOMA AND PARATHYROID CARCINOMA PRESENTING WITH SEVERE HYPERCALCEMIA

Yıl 2020, Cilt: 21 Sayı: 3, 285 - 288, 01.07.2020

Türkan Paşalı Kilit , Kevser I Onbaş Gül Sena Topal Filiz Özyiğit

https://doi.org/10.18229/kocatepetip.762106

Öz

Hypercalcemia is a pathological condition characterized by the amount of calcium passing through the extracellular fluid from the bones, the gastrointestinal tract, or the kidneys, which is greater than the amount of calcium removed from the plasma. Hypercalcemia due to primary hyperparathyroidism and malign diseases constitutes more than 90% of all hypercalcemia cases. The most frequent cause of hypercalcemia is malignancy in patients with serious illness that should be hospitalized, and primary hyperparathyroidism in outpatients. Urgent treatment is required for patients with a serum calcium level above 15 mg/dl or with symptomatic hypercalcemia. Parathyroid carcinoma is a very rare endocrine composing, with less than 1% of primary hyperparathyroidism cases. Parathyroid carcinoma can be suspected in cases of significantly high serum calcium and parathormone levels, a palpable parathyroid gland, and severe symptoms. In this case report, we presented a case of primary hyperparathyroidism with parathyroid adenoma and parathyroid carcinoma, which was presented with symptoms due to severe hypercalcemia.

Anahtar Kelimeler

Hypercalcemia, Primary hyperparathyroidism, Parathyroid adenoma, Parathyroid carcinoma

CİDDİ HİPERKALSEMİ İLE PREZENTE OLAN PARATİROİD ADENOMU VE PARATİROİD KARSİNOMA OLGUSU

Öz

Hiperkalsemi kemikler, gastrointestinal sistem veya böbreklerden hücre dışı sıvıya geçen kalsiyum miktarı, plazmadan uzaklaştırılan kalsiyum miktarından fazla olması olarak tanımlanan patolojik bir durumdur. Primer hiperparatiroidizm ve malign hastalıklara bağlı hiperkalsemi, tüm hiperkalsemi olgularının %90’ından fazlasını oluşturmaktadır. Hastanede yatışı gerektirecek ciddiyette hastalığı olanlarda en sık hiperkalsemi nedeni malignite, poliklinik hastalarında ise primer hiperparatiroididir. Serum kalsiyum düzeyi 15 mg/dl'nin üzerinde olan veya semptomatik hiperkalsemisi olan hastaların acil tedavisi gereklidir. Paratiroid karsinomu çok ender görülen bir endokrin tümör olup, primer hiperparatiroidizm olgularının %1’inden daha azını oluşturur. Önemli ölçüde yükselmiş serum kalsiyum ve parathormon düzeyleri, palpe edilebilir bir paratiroid bezi olması ve ağır semptomların olması durumunda paratiroid karsinomundan şüphelenilebilir. Bu olgu sunumunda ciddi hiperkalsemiye bağlı semptomlarla başvuran, paratiroid adenomu ve paratiroid karsinomunun birlikte görüldüğü primer hiperparatiroidili bir vakayı sunduk

Anahtar Kelimeler

Paratiroid karsinoma,, Hiperkalsemi,, Primer hiperparatiroidizm

Kaynakça

• 1. Carroll MF, Schade DS. A practical approach to hypercalcemia. Am Fam Physician 2003; 67:1959–66.
• 2. Cady B, Rossi RL (Editörler). Surgery of the Thyroid and Parathyroid Glands (Major Problems in Clinical Surgery). In: Clerkin EP. Hyperparathyroidism. 3üncü Baskı, ABD: WB Saunders Company, 1991:243-53.
• 3. Wilson JD, Foster DW, Kronenberg HM, Larsen PR (Editörler). Williams Textbook of Endocrinology. In: Bringhurst FR, Demay MB, Kronenberg HM. Hormones and disorders of mineral metabolism. 9uncu Baskı, ABD: WB Saunders Company, 1998:1155-209.
• 4. De Groot LJ (Editör). Endocrinology. In: Habener J, Arnold A, Potts JT. Hyperparathyroidism. 3üncü Baskı, ABD: WB Saunders Company, 1995:1044-66.
• 5. Bilezikian JP, Silverberg SJ. Primary hyperparathyroidism: Still evolving? Journal of Bone and Mineral Research 1997;12:856-62.
• 6. Strewler GJ, Nissenson RA. Hypercalcemia in malignancy. West J Med 1990;153:635-40.
• 7. Stewart AF. Clinical practice. Hypercalcemia associated with cancer. N Engl J Med 2005; 352:373.
• 8. Carroll MF, Schade DS. A practical approach to hypercalcemia. Am Fam Physician 2003; 67: 1959-66.
• 9. Shaha AR, Shah JP. Parathyroid carcinoma: a diagnostic and therapeutic challenge. Cancer 1999;86:378-80.
• 10. Awumey EM, Mitra DA, Hollis BW, Kumar R, Bell NH. Vitamin D metabolism is altered in Asian Indians in the southern United States: a clinical research center study. J Clin Endocrinol Metab 1998;83:169-73.
• 11. Eslamy HK, Ziessman HA. Parathyroid scintigraphy in patients with primary hyperparathyroidism: 99mTc sestamibi SPECT and SPECT/CT. Radiographics 2008;28:1461-76.
• 12. Gotthardt M, Lohmann B, Behr TM, et al. Clinical value of parathyroid scintigraphy with technetium-99 m methoxyisobutylisonitrile: Discrepancies in clinical data and a systematic metaanalysis of the literature. World J Surg 2004;28:100-7.
• 13. Moralidis E. Radionuclide parathyroid imaging: a concise, updated review Hell J Nucl Med 2013;16:125-33.
• 14. Cheah WK, Rauff A, Lee KO, Tan W. Parathyroid carcinoma: A case series. Ann Acad Med Singapore 2005; 34: 443-6.
• 15. Wang CC, Chen YC, Shiang JC, Lin SH, Chu P, Wu CC. Hypercalcemic crisis successfully treated with prompt calcium free hemodialysis. Am J Emerg Med 2009;27:1174.e1-3.