title: Large goiter and multiple rib tumors.
abstract: We report an interesting case of a 47-yr-old who had a large goiter and multiple rib tumors. The patient was initially suspected of having thyroid cancer, which had metastasized on the ribs, based on imaging studies. However, laboratory tests revealed a high level of ionized calcium and parathyroid hormone (PTH). The large goiter was diagnosed as having parathyroid tumors owing to the high level of PTH in the tissue fluid. The biopsy specimen from a rib tumor was diagnosed as containing brown tumors associated with primary hyperparathyroidism (PHP). The patient also had prolactinoma and pancreatic gastrinoma. Her daughter had both prolactinoma and PHP, and her brother and her father had PHP. Thus, the patient was diagnosed as having multiple endocrine neoplasia type 1.
authors.affiliation: First Department of Internal Medicine, Kagawa Medical University, Japan. makoto@kms.ac.jp
authors.forename: M
authors.initials: M
authors.lastname: Sato
authors.forename: T
authors.initials: T
authors.lastname: Kobayashi
authors.forename: H
authors.initials: H
authors.lastname: Dobashi
authors.forename: H
authors.initials: H
authors.lastname: Ohye
authors.forename: S
authors.initials: S
authors.lastname: Matsubara
authors.forename: K
authors.initials: K
authors.lastname: Murao
authors.forename: A
authors.initials: A
authors.lastname: Miyauchi
authors.forename: S
authors.initials: S
authors.lastname: Kobayashi
authors.forename: J
authors.initials: J
authors.lastname: Takahara
mesh_terms: D000328:Adult; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D002118:Calcium / Q000097:blood; D003937:Diagnosis, Differential; D005260:Female; D015408:Gastrinoma / Q000150:complications / Q000175:diagnosis; D006042:Goiter / Q000175:diagnosis*; D006801:Humans; D006961:Hyperparathyroidism / Q000150:complications / Q000175:diagnosis; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications / Q000175:diagnosis; D010281:Parathyroid Hormone / Q000032:analysis / Q000097:blood; D010282:Parathyroid Neoplasms / Q000737:chemistry / Q000150:complications / Q000175:diagnosis*; D010911:Pituitary Neoplasms / Q000150:complications / Q000175:diagnosis; D015175:Prolactinoma / Q000150:complications / Q000175:diagnosis; D012272:Ribs; D014057:Tomography, X-Ray Computed
chemical_list: D010281:Parathyroid Hormone; D002118:Calcium