title: Successful palliation of hypercalcemia secondary to metastatic parathyroid cancer: an unusual indication for hepatic resection.
abstract: Primary carcinoma of the parathyroid gland is a rare disease. It is often diagnosed after recurrence of hyperparathyroidism following resection for presumed adenomatous disease. Local and distant recurrence is high and aggressive resection is advocated. Patients with parathyroid cancer are frequently plagued by severe hypercalcemia, which is often refractory to medical therapy. Herein we describe the case of a patient with metastatic parathyroid cancer localized to the liver. The patient was treated with a palliative hepatic resection for the management of persistent and refractory hypercalcemia. Intraoperative parathyroid hormone levels were utilized as an adjunct to determine successful metastatectomy. Our case highlights the importance of an aggressive approach to patients with metastatic parathyroid cancer, as well as the utility of intraoperative parathyroid hormone levels to confirm successful extirpation of disease.
authors.affiliation: Department of Surgery, The University of Chicago, 5841 South Maryland Avenue, Mail Code 5031, Chicago, Illinois 60637, USA.
authors.forename: James J
authors.initials: JJ
authors.lastname: Mezhir
authors.forename: Marcovalerio
authors.initials: M
authors.lastname: Melis
authors.forename: Ryan C
authors.initials: RC
authors.lastname: Headley
authors.forename: Rish K
authors.initials: RK
authors.lastname: Pai
authors.forename: Mitchell C
authors.initials: MC
authors.lastname: Posner
authors.forename: Edwin L
authors.initials: EL
authors.lastname: Kaplan
mesh_terms: D000368:Aged; D002118:Calcium / Q000097:blood; D002277:Carcinoma / Q000150:complications / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology / Q000628:therapy*; D008113:Liver Neoplasms / Q000556:secondary* / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D010166:Palliative Care; D010281:Parathyroid Hormone / Q000097:blood; D010282:Parathyroid Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery; D016105:Parathyroidectomy; D016896:Treatment Outcome
chemical_list: D010281:Parathyroid Hormone; D002118:Calcium