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.
Department of General Medicine, Flinders Medical Centre and School of Medicine, Flinders University, Bedford Park, Adelaide, SA, Australia. tuck.yong@health.sa.gov.au
Tuck Y
TY
Yong
Jordan Y Z
JY
Li
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