title: Parathyroid carcinoma and hungry bone syndrome.
abstract: We hereby report two patients with parathyroid carcinoma presenting extremely high calcium and PTH levels, severe bone disease, and palpable neck mass at diagnosis. They both underwent parathyroidectomy, and one of them evolved to lung metastasis. Important hypocalcemia was observed after surgery in both: after parathyroidectomy in one patient, and only after surgical removal of the metastasis in the other. Both required intravenous calcium replacement, thus revealing hungry bone syndrome (HBS). HBS usually reflects rapid mineralization after correction of hyperparathyroidism. The more severe the bone disease before surgery, the more prone the patient is to HBS after surgery. Despite being an unfavorable outcome, HBS state suggests that surgical removal of hypersecretory parathyroid tissue was accomplished. In this study, HBS was observed in both patients, who presented severe bone disease prior to surgery. HBS would be expected post-operatively in successful parathyroid carcinoma removal.
authors: Division of Endocrinology and Metabolism, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp/ EPM), Sao Paulo, SP, Brazil. moniqueohe@uol.com.br
authors: Monique Nakayama
authors: MN
authors: Ohe
authors: Rodrigo Oliveira
authors: RO
authors: Santos
authors: Flavio
authors: F
authors: Hojaij
authors: Murilo Catafesta
authors: MC
authors: Neves
authors: Ilda Sizue
authors: IS
authors: Kunii
authors: Denise
authors: D
authors: Orlandi
authors: Luisa
authors: L
authors: Valle
authors: Carla
authors: C
authors: Martins
authors: Carolina
authors: C
authors: Janovsky
authors: Rimarcs
authors: R
authors: Ferreira
authors: Roseane
authors: R
authors: Delcelo
authors: Ana Maria
authors: AM
authors: Domingos
authors: Marcio
authors: M
authors: Abrahão
authors: Onivaldo
authors: O
authors: Cervantes
authors: Marise
authors: M
authors: Lazaretti-Castro
authors: Jose Gilberto Henriques
authors: JG
authors: Vieira
mesh_terms: D000328:Adult; D000368:Aged; D002118:Calcium / Q000008:administration & dosage; D002277:Carcinoma / Q000556:secondary / Q000601:surgery; D005260:Female; D006801:Humans; D006996:Hypocalcemia / Q000209:etiology*; D008175:Lung Neoplasms / Q000556:secondary; D010282:Parathyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D016105:Parathyroidectomy / Q000009:adverse effects*; D011184:Postoperative Period; D013577:Syndrome
chemical_list: D002118:Calcium