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Relapsing hypercalcemia – a hard diagnostic nut to crack: a case report


Authors: Halmová Henrieta 1;  Halm Filip 2;  Vaňuga Peter 3;  Sičák Marián 4;  Szépe Peter 5;  Slávik Matej 7
Authors‘ workplace: Endokrinologická ambulancia OSTEOMED, s. r. o., Lučenec 1;  Radiodiagnostické oddělení Nemocnice Na Homolce, Praha 2;  Endokrinologické oddelenie NEDÚ, Ľubochňa 3;  ORL klinika, Ústredná vojenská nemocnica SNP Ružomberok – FN 4;  Ústav patologickej anatómie JLF UK a UN Martin 5;  Martinské bioptické centrum, s. r. o., Martin 6;  Ústav patologickej anatómie, Ústredná vojenská nemocnica SNP Ružomberok – FN 7
Published in: Clinical Osteology 2021; 26(1): 44-52
Category:

Overview

The two most common causes of hypercalcemia are the primary hyperparathyroidism and the malignant tumors. Etiology of primary hyperparathyroidism is frequently associated with adenoma of parathyroid gland, less frequently with hyperplasia of parathyroid gland and rarely with carcinoma of parathyroid gland. In below presented clinical case we demonstrate the rare case of the premenopausal woman indicated with an anamnesis of bone pain, densitometric examination showed significantly decreased bone density and laboratory results proved hypercalcemia, hypophosphatemia and significantly increased parathormone level. After successful surgery of the right lower parathyroid gland adenoma there has been expected decline in serum calcium and parathormone level. At the subsequent visit, a relapse of hypercalcemia and an increase of parathormone level appeared, furthermore a new solitary node in the left thyroid lobe has been diagnosed. After subsequent detailed examination, the node has been diagnosed as the parathyroid carcinoma with atypical location in the thyroid left lobe.

Keywords:

alkaline phosphatase – hypercalcemia – parathyroid adenoma – parathyroid hormone (PTH) – primary hyperparathyroidism (PHPT) – Z-score


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Labels
Clinical biochemistry Paediatric gynaecology Paediatric radiology Paediatric rheumatology Endocrinology Gynaecology and obstetrics Internal medicine Orthopaedics General practitioner for adults Radiodiagnostics Rehabilitation Rheumatology Traumatology
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