A case of calcitonin-producing parathyroid adenoma with primary hyperparathyroidism.
A 57-year-old female was admitted to our hospital with general lassitude, loss of appetite, nausea, upper abdominal pain, thirst, polydipsia and polyuria. On admission, she had an asymmetrical pear-shaped tumor in the right supraclavicular region and severe hypercalcemia. Plasma C-PTH was elevated to 22.72ng/ml. Plasma calcitonin was also elevated to 336 pg/ml. She died of respiratory and cardiac failure of two weeks after admission without any positive response to the treatment, including hemodialysis. Pathohistologically, the tumor was a parathyroid adenoma. The concentrations of C-PTH, intact PTH and calcitonin in the tumor tissue were markedly high: 4.56 micrograms/g wet, 13.9 ng/g wet and 50.7 ng/g wet, respectively. Immunohistologically, the tumor cells and the fibrous stroma were stained strongly positive to rabbit anti-human calcitonin antibody and rabbit anti-human N-PTH antibody by indirect immunoperoxidase staining. Calcitonin-producing tumors, except for medullary thyroid carcinoma are rarely reported. To our knowledge, this is the first report of such a calcitonin-producing parathyroid adenoma associated with primary hyperparathyroidism.
Maeda
T
T
Medical Department of Nippon Steel Corporation Muroran Works Hospital, Muroran, Japan.
Ashie
T
T
Kikuiri
K
K
Takakura
M
M
Ise
T
T
Shimamoto
K
K
D000236:Adenoma / Q000150:complications / Q000378:metabolism* / Q000473:pathology; D002116:Calcitonin / Q000097:blood / Q000378:metabolism*; D005260:Female; D006801:Humans; D006961:Hyperparathyroidism / Q000150:complications*; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010282:Parathyroid Neoplasms / Q000150:complications / Q000378:metabolism* / Q000473:pathology; D010446:Peptide Fragments / Q000097:blood / Q000378:metabolism*
D010281:Parathyroid Hormone; D010446:Peptide Fragments; C023443:carboxyl-terminal parathyroid hormone; D002116:Calcitonin