Mediastinal parathyroid carcinoma presenting with severe skeletal manifestations.
Parathyroid carcinoma is a rare malignancy, accounting for about 1% of primary hyperparathyroidism. We report the case of a 23-year-old man who presented with poorly united mid-shaft fracture of the left femur with severe hypercalcaemia in the setting of 99 mTc sestamibi-avid lesions in the mediastinal and thoracic vertebrae. The patient underwent surgery, and histopathology revealed a low-grade parathyroid carcinoma. After surgery, the patient developed severe hungry bone syndrome requiring intensive calcium, magnesium and active vitamin D supplementation. A review of the literature was undertaken with regards to mediastinal parathyroid carcinoma, management of refractory hypercalcaemia in this setting and hungry bone syndrome.
Yong
Tuck Y
TY
Department of General Medicine, Flinders Medical Centre and School of Medicine, Flinders University, Bedford Park, Adelaide, SA, Australia. tuck.yong@health.sa.gov.au
Li
Jordan Y Z
JY
D001842:Bone and Bones / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology*; D002118:Calcium / Q000627:therapeutic use; D006801:Humans; D006934:Hypercalcemia / Q000188:drug therapy / Q000503:physiopathology; D008274:Magnesium / Q000627:therapeutic use; D008297:Male; D008479:Mediastinal Neoplasms / Q000473:pathology / Q000503:physiopathology; D010282:Parathyroid Neoplasms / Q000473:pathology / Q000503:physiopathology; D011859:Radiography; D019275:Radiopharmaceuticals / Q000378:metabolism; D013577:Syndrome; D017256:Technetium Tc 99m Sestamibi / Q000378:metabolism; D014807:Vitamin D / Q000627:therapeutic use; D055815:Young Adult
D019275:Radiopharmaceuticals; D014807:Vitamin D; D017256:Technetium Tc 99m Sestamibi; D008274:Magnesium; D002118:Calcium