Presentation
Case Presentation A 63 year-old gentleman with known hypertension presented in October 2016 with diffuse bony aches, polyuria, polydipsia, constipation, fatigue, loss of appetite, and weight loss of 25 pounds over two months. [frontiersin.org]
The three remaining parathyroids presented normal appearance. [scielo.br]
A 13-year-old African American girl with a history of parathyroid adenoma, diagnosed at 8 years of age with multiple recurrences, presented with hypercalcemia and elevated parathyroid hormone when her disease had been reclassified as malignant. [journals.lww.com]
World J Surg Oncol 3: 39 CrossRef PubMed Google Scholar Messerer CL, Bugis SP, Baliski C, Wiseman SM (2006) Normocalcemic parathyroid carcinoma: an unusual clinical presentation. [link.springer.com]
Patients present with primary hyperparathyroidism : elevated serum calcium levels and elevated serum parathyroid hormone levels. [radiopaedia.org]
Entire Body System
- Fatigue
This results in multisystem effects including osteoporosis, renal calculi, constipation, peptic ulcers, mental changes, fatigue, and depression. They are usually oval or bean-shaped, but larger adenomas can be multilobulated. [radiopaedia.org]
Other constitutional symptoms associated with PHPT such as fatigue, loss of concentration, bony pain, polydipsia, polyuria, peptic ulcerations, pancreatitis, and depression may also be noted. [frontiersin.org]
- Swelling
Case 2 A 42-year-old female patient was referred to the emergency ward at Hospital São Paulo in July 2011, complaining about ocular disturbances in the previous five months with ptosis, palpebral swelling, and diplopia. [scielo.br]
- Asymptomatic
Intrathyroidal parathyroid carcinoma presenting as asymptomatic high normal serum calcium and slightly elevated intact parathyroid hormone: a case report and review of literature. [frontiersin.org]
Respiratoric
- Hoarseness
Change in voice such as hoarseness. Trouble swallowing. Other conditions may cause the same signs and symptoms as parathyroid cancer. Check with your doctor if you have any of these problems. [cancer.gov]
Hoarseness, resulting from recurrent laryngeal nerve palsy, and palpably enlarged lymph nodes can also provide a clue to the presence of a parathyroid carcinoma. [frontiersin.org]
Gastrointestinal
- Constipation
This results in multisystem effects including osteoporosis, renal calculi, constipation, peptic ulcers, mental changes, fatigue, and depression. They are usually oval or bean-shaped, but larger adenomas can be multilobulated. [radiopaedia.org]
Constipation. Trouble thinking clearly. Other signs and symptoms of parathyroid cancer include the following: Pain in the abdomen, side, or back that doesn't go away. Pain in the bones. A broken bone. A lump in the neck. [cancer.gov]
Case Presentation A 63 year-old gentleman with known hypertension presented in October 2016 with diffuse bony aches, polyuria, polydipsia, constipation, fatigue, loss of appetite, and weight loss of 25 pounds over two months. [frontiersin.org]
She also complained about nausea and vomiting, polyuria and polydipsia, constipation and painful gait involving the right hip and lumbar spine. She had already reported several episodes of nephrolithiasis treated by lithotripsy. [scielo.br]
- Loss of Appetite
Loss of appetite. Weight loss for no known reason. Being much more thirsty than usual. Urinating much more than usual. Constipation. Trouble thinking clearly. [cancer.gov]
Case Presentation A 63 year-old gentleman with known hypertension presented in October 2016 with diffuse bony aches, polyuria, polydipsia, constipation, fatigue, loss of appetite, and weight loss of 25 pounds over two months. [frontiersin.org]
CASE REPORTS Case 1 A 65-year-old female patient was seen at the emergency ward at Hospital São Paulo – a Federal University Hospital – in 2008, complaining of fever, dysuria, nausea, loss of appetite, and loss of weight, as well as general malaise. [scielo.br]
- Polydipsia
Other constitutional symptoms associated with PHPT such as fatigue, loss of concentration, bony pain, polydipsia, polyuria, peptic ulcerations, pancreatitis, and depression may also be noted. [frontiersin.org]
She also complained about nausea and vomiting, polyuria and polydipsia, constipation and painful gait involving the right hip and lumbar spine. She had already reported several episodes of nephrolithiasis treated by lithotripsy. [scielo.br]
Skin
- Ulcer
This results in multisystem effects including osteoporosis, renal calculi, constipation, peptic ulcers, mental changes, fatigue, and depression. They are usually oval or bean-shaped, but larger adenomas can be multilobulated. [radiopaedia.org]
Other constitutional symptoms associated with PHPT such as fatigue, loss of concentration, bony pain, polydipsia, polyuria, peptic ulcerations, pancreatitis, and depression may also be noted. [frontiersin.org]
Workup
X-Ray
- Nephrolithiasis
She was initially diagnosed with acute exacerbation of chronic renal failure related to recurrent nephrolithiasis. At clinical examination, a palpable neck mass was observed. [scielo.br]
Indeed, severe nephrolithiasis, nephrocalcinosis, and impaired renal function with bone loss is noted in nearly 80% of affected patients ( 3 ). The latter may include osteitis fibrosa cystica, diffuse osteopenia, or even pathologic fractures. [frontiersin.org]
Treatment
When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. [cancer.gov]
Parathyroid Carcinoma Challenges in Diagnosis and Treatment. Hematol Oncol Clin N Am 2012; 26: 1221-38. [ Links ] 3. Schaapveld M, Jorna FH, Aben KK. [scielo.cl]
Parathyroid cancer: etiology, clinical presentation and treatment. Anticancer research. 2006;26(6C):4803-7. 32. Enomoto K, Uchino S, Ito A, Watanabe S, Shibuya H, Enomoto Y, et al. [revista.spcir.com]
The optimal treatment is related to early diagnosis with clinical and laboratorial suspicion for this entity prior to surgery, once complete resection of primary site is intended. [scielo.br]
Int Surg 90: 18–22 PubMed Google Scholar Daphnis E, Stylianou K, Katsipi I, et al. (2006) Parathyromatosis and the challenge of treatment. [link.springer.com]
Prognosis
Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options depend on the following: Whether the calcium level in the blood can be controlled. The stage of the cancer. [cancer.gov]
Treatment and prognosis Surgery is successful in treating primary hyperparathyroidism caused by parathyroid adenomas in 95-98% of cases 17. [radiopaedia.org]
Incidence and prognosis of parathyroid gland carcinoma: a population-based study in The Netherlands estimating the preoperative diagnosis. Am J Surg 2011; 202 (5): 590-74. [ Links ] 4. Cetani F, Pardi E, Marcocci C. Update on parathyroid Carcinoma. [scielo.cl]
Etiology
Parathyroid cancer: etiology, clinical presentation and treatment. Anticancer research. 2006;26(6C):4803-7. 32. Enomoto K, Uchino S, Ito A, Watanabe S, Shibuya H, Enomoto Y, et al. [revista.spcir.com]
Epidemiology
Hypoparathyroidism in the adult: epidemiology, diagnosis, pathophysiology, target-organ involvement, treatment, and challenges for future research. J Bone Miner Res. 2011;26(10):2317-37. [ Links ] Correspondence to: Monique Nakayama Ohe Av. Cons. [scielo.br]
Pathophysiology
Hypercalcemia in the Intensive Care Unit: A review pathophysiology, diagnostic and modern therapy. J Intensive Care Med 2015; 30 (5): 235-52. [ Links ] 34. LeGrand S, Leskuski D, Zama I. [scielo.cl]
Hypoparathyroidism in the adult: epidemiology, diagnosis, pathophysiology, target-organ involvement, treatment, and challenges for future research. J Bone Miner Res. 2011;26(10):2317-37. [ Links ] Correspondence to: Monique Nakayama Ohe Av. Cons. [scielo.br]
Prevention
However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].” [cancer.gov]
HBS is considered a complication of parathyroid surgery observed in 13-30% of cases (18), and some studies advocate the use of bisphosphonates prior to surgery in order to prevent this post-operative outcome (19). [scielo.br]