Journal of Shandong University (Health Sciences) ›› 2023, Vol. 61 ›› Issue (1): 62-68.doi: 10.6040/j.issn.1671-7554.0.2022.0851

• 临床医学 • Previous Articles    

A case report of parathyroid carcinoma with parathyroid crisis as the primary clinical manifestation

ZENG Yanping1,2, YAN Shengtao3, LIU Xiaoyu4, JIANG Ziqing1   

  1. 1. The First Clinical College, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, China;
    2. Emergency Department, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong, China;
    3. Emergency Department, China-Japan Friendship Hospital, Beijing 100029, China;
    4. Graduate School of Peking Union Medical Collage, Beijing 100730, China
  • Published:2023-01-10

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Abstract: Objective To analyze and report the diagnosis and treatment of a case of pathologically confirmed parathyroid carcinoma with parathyroid crisis as the primary clinical manifestation, in order to improve clinicians understanding of this rare disease. Methods Clinical and laboratory examination data of a patient initially diagnosed as parathyroid crisis and finally diagnosed as parathyroid carcinoma were collected and analyzed, and relevant literature was reviewed. Results A 70-year-old female was admitted due to disorder of consciousness, severe hypercalcemia, abnormal elevation of parathyroid hormone(PTH), pneumonia, renal insufficiency, and venous thrombosis of lower limbs. After anti-infection, salmon calcitonin, desumumab, anticoagulation, and other treatments, the patients condition improved for a time, but then deteriorated again. After secondary evaluation, upgraded anti-infection, sinacaser hydrochloride tablets for hypercalcemia and dilation, the patients condition was stabled and improved, which created conditions for surgical treatment. Parathyroid carcinoma was finally confirmed by postoperative gross pathological specimens. Conclusion Peripheral thyroid nodules, serum calcium >3.5 mmol/L, and PTH >10 times of the upper limit of normal value, suggest the possibility of parathyroid carcinoma. The combination of neck ultrasound and 99mTc-MIBI can improve the detection accuracy. Surgery is still the key to treatment, although conservative medical treatment can relieve clinical symptoms. Extended resection margin may benefit tumor clearance, but there is no unified standard at present. Due to the high recurrence rate of this disease, long-term follow-up and timely treatment may improve the survival rate.

Key words: Parathyroid crisis, Parathyroid carcinoma, Hypercalcemia, Surgical treatment

CLC Number: 

  • R736.2
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