tailieunhanh - Báo cáo y học: "The management of acute parathyroid crisis secondary to parathyroid carcinoma: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: The management of acute parathyroid crisis secondary to parathyroid carcinoma: a case report | Rock et al. Journal of Medical Case Reports 2010 4 28 http content 4 1 28 jAc JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access The management of acute parathyroid crisis secondary to parathyroid carcinoma a case report Kathy Rock Nariman Fattah Diarmuid O Malley Enda McDermott 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 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 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 4cm 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 .