title: Concurrent parathyroid adenomas and carcinoma in the setting of multiple endocrine neoplasia type 1: presentation as hypercalcemic crisis.
abstract: We describe a patient with multiple endocrine neoplasia type 1 characterized by the simultaneous occurrence of parathyroid cancer, parathyroid adenomas, and pancreatic gastrinoma, who presented with an episode of acute hypercalcemia. The rapid parathyroid hormone assay provided a basis for the diagnosis of parathyroid hyperfunction. Mediastinal metastasis of the parathyroid carcinoma was found at autopsy. However, the staining of pancreatic and gastric tissue for parathyroid hormone-related protein does not make it possible to exclude completely the contribution of this peptide in mediating the hypercalcemia. To our knowledge, this is the first reported case of parathyroid carcinoma as part of the multiple endocrine neoplasia type 1 syndrome.
authors.affiliation: Department of Clinical Sciences, University of Rome La Sapienza, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Dionisi
authors.forename: Salvatore
authors.initials: S
authors.lastname: Minisola
authors.forename: Jessica
authors.initials: J
authors.lastname: Pepe
authors.forename: Simona
authors.initials: S
authors.lastname: De Geronimo
authors.forename: Federica
authors.initials: F
authors.lastname: Paglia
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Memeo
authors.forename: Lorraine A
authors.initials: LA
authors.lastname: Fitzpatrick
mesh_terms: D000208:Acute Disease; D000236:Adenoma / Q000175:diagnosis / Q000473:pathology*; D000328:Adult; D002277:Carcinoma / Q000175:diagnosis / Q000473:pathology*; D017809:Fatal Outcome; D015408:Gastrinoma / Q000175:diagnosis / Q000473:pathology*; D005755:Gastrins / Q000097:blood; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology*; D006961:Hyperparathyroidism / Q000209:etiology; D008297:Male; D018761:Multiple Endocrine Neoplasia Type 1 / Q000175:diagnosis / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000473:pathology*; D010281:Parathyroid Hormone / Q000097:blood; D010282:Parathyroid Neoplasms / Q000175:diagnosis / Q000473:pathology*
chemical_list: D005755:Gastrins; D010281:Parathyroid Hormone