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Title: Parathyroid carcinoma : clinical course, diagnosis and management
Authors: Captur, Gabriella
Micallef Grimaud, Lisa
Betts, Alexandra
DeGaetano, James
Attard, Alex
Vassallo, Josanne
Keywords: Parathyroid neoplasms -- Malta -- Case studies
Parathyroid neoplasms -- Treatment
Hyperparathyroidism, Primary -- Diagnosis
Issue Date: 2010
Publisher: Malta Medical Journal
Citation: Malta Medical Journal. 2010, Vol.22(2), p. 25-30
Abstract: Parathyroid carcinoma is a rare cause of primary hyperparathyroidism often resulting in severe hypercalcaemia. It tends to follow a rather aggressive course with a high propensity for locoregional spread and distant metastasis. En bloc resection is the mainstay of treatment, with surgery also playing a role in the palliation of hypercalcaemia for recurrent and metastatic disease. While adjuvant chemotherapy and radiotherapy have shown disappointing outcomes, bisphosphonates and calcimimetic agents are effective in the management of recalcitrant hypercalcaemia in parathyroid carcinoma. We report a case of parathyroid carcinoma in a lady who initially presented with a neck mass, severe hypercalcaemia, a bony swelling over the shin and elevated parathyroid hormone levels. The diagnosis was confirmed histologically following a thyroid lobectomy, isthmectomy and parathyroidectomy. In the three years which followed the patient received two courses of palliative radiotherapy, two thoracotomies for pulmonary metastatectomy, an extensive neck re-exploration and fashioning of a tracheostomy for aggressive local recurrence with invasion of the larynx.
Appears in Collections:MMJ, Volume 22, Issue 2
MMJ, Volume 22, Issue 2
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