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Parathyroid carcinoma: A rare case with mandibular brown tumor

Nebenschilddrüsen-Karzinom: Ein seltener Fall mit mandibulärem braunem Tumor

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Zusammenfassung

Karzinome der Nebenschilddrüse machen weniger als 1 % der Fälle des primären Hyperparathyroidismus aus. Bei einem mittleren Alter von 40 ist die Häufigkeit bei Männern und Frauen etwa gleich. Dabei ist in etwa der Hälfte der Patienten die Palpation einer Raumforderung möglich, das Serum-Kalzium ist meist höher als 14 mg/dl. In einer Fallstudie wird ein 21-jähriger, männlicher Patient mit schmerzloser, nicht verschieblicher mandibulärer Raumforderung zunächst unklarer Genese vorgestellt. Seine Symptome beinhalten Müdigkeit, Gewichtsverlust, Heiserkeit, Polydipsie, Polyurie, Hämaturie, rekurrente Nierensteine und Episoden von Obstipation und Diarrhoen. Eine Biopsie der Mandibula bestätigte den Verdacht auf einen braunen Tumor; das Serum-Kalzium betrug 15.4 mg/dl. Der Ultraschall der Schilddrüse ergab echoarme Bereiche mit einem Verdacht auf Parathyriodea-Adenom, später wurde ein Karzinom der Parathyroidea bestätigt und eine en-bloc Resektion durchgeführt. Während der folgenden zwei Jahre fanden sich keine Hinweise auf eine Rekurrenz oder Hyperkalzämie. Der vorgestellte Fall eines Nebenschilddrüsen-Karzinomes in Verbindung mit einem braunen Tumor ist der zweite beschriebene Fall weltweit.

Summary

Parathyroid carcinoma constitutes less than 1 % of primary hyperparathyroidism. The male to female ratio is approximately equal and the mean age at presentation is 40 years. In about half of the patients there is a palpable cervical mass, and serum calcium level is usually above 14 mg/dl. In a case report we present a 21-year-old man with a non-tender, non-mobile bulging mandibular mass. He suffered from fatigue, recent weight loss, hoarseness, polydipsia, polyuria, hematuria, recurrent renal stones and bouts of constipation and diarrhea. A mandibular biopsy confirmed brown tumor. Serum calcium level was 15.4 mg/dl. Cervical ultrasound revealed a hypoecho area suspicious of parathyroid adenoma. Parathyroid carcinoma was later confirmed and en bloc resection was performed. During a two-year follow up there has been no evidence of recurrence or hypercalcemia. This unique case of parathyroid carcinoma in conjunction with brown tumor is the second reported case worldwide.

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Authors and Affiliations

  1. Department of Physiology and Pathophysiology, University of Heidelberg, Germany

    Payam S. Pahlavan

  2. Department of Internal Medicine, University of Heidelberg, Germany

    Payam S. Pahlavan

  3. Department of Family Medicine, Maccabi Health Services, Israel

    Marianne C. Severin

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  1. Payam S. Pahlavan
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  2. Marianne C. Severin
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Correspondence to Payam S. Pahlavan.

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Pahlavan, P., Severin, M. Parathyroid carcinoma: A rare case with mandibular brown tumor. Wien Klin Wochenschr 118, 175–179 (2006). https://doi.org/10.1007/s00508-006-0566-5

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