CASE REPORT
Primary hyperparathyroidism and metastatic carcinoma within parathyroid gland
1 Department of Histopathology, Royal Victoria Hospital, Belfast, Northern Ireland
2 Department of Endocrine Surgery, Royal Victoria Hospital, Belfast, Northern Ireland
Correspondence to:
Correspondence to:
Dr L Venkatraman
Department of Histopathology, Royal Group of Hospitals Trust, Grosvenor Road, Belfast BT12 6BL, Northern Ireland
Accepted 30 January 2006
Keywords: metastatic adenocarcinoma; parathyroid; primary hyperparathyroidism; hypercalcaemia
| The first 150 words of the full text of this article appear below. |
Involvement of the parathyroid glands by metastatic tumour is rare. In autopsy studies of known cancer patients, it was noted in 0.2–11.9% of individuals.1 Hypoparathyroidism and hypocalcaemia as a result of parathyroid destruction by tumour is unusual.2,3 We report a case of hyperparathyroidism due to parathyroid hyperplasia with simultaneous occurrence of metastatic bronchogenic adenocarcinoma to a parathyroid gland.
A 75-year-old woman was referred with hypercalcaemia. Six months earlier she had presented to an osteoporosis clinic with generalised pain in the upper limbs. She reported anorexia and mild weight loss but was otherwise asymptomatic. Specifically there were no respiratory symptoms. A bone density scan revealed osteoporosis. Routine biochemical investigations revealed hypercalcaemia, raised parathyroid hormone level and normal renal function (table 1
). A parathyroid pertechnetate/MIBI subtraction scan suggested the presence of an enlarged left superior parathyroid gland. The patient was a non-smoker and had no significant past medical history. Plain radiographs
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