Abstract
We report herein the case of a 46-year-old woman on hemodialysis (HD) who developed recurrent renal hyperparathyroidism induced by lung metastasis from parathyroid carcinoma. The patient had been commenced on HD for chronic renal failure about 20 years earlier and had undergone a parathyroidectomy for advanced renal hyperparathyroidism 8 years later. After the initial operation, further explorations of the neck were performed due to recurrence, despite which the hyperparathyroidism persisted and she was finally referred to our department. The appearance of multiple coinlike lesions ona chest X-ray and computed tomography led to the diagnosis of recurrent hyperparathyroidism induced by lung metastasis from parathyroid carcinoma. A pulmonary wedge resection was performed and the metastatic parathyroid nodules were removed. Of the several hypotheses about the etiology of parathyroid carcinoma in HD patients, it is most likely that the parathyroid hyperplasia induced by chronic renal failure develops into carcinoma. Even in renal hyperparathyroidism, we should bear in mind the possibility that metastatic parathyroid carcinoma is a possible source of excess parathyroid hormone secretion at recurrence.
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References
Obara T, Fujimoto Y (1991) Diagnosis and treatment of patients with parathyroid carcinoma: An update and review. World J Surg 15:738–744
Anderson BJ, Samaan NA, Vassilopoulou-Sellin R, Ordonez NG, Hickey RC (1983) Parathyroid carcinoma: Feature and difficulties in diagnosis and management. Surgery 94:906–915
Vetto JT, Brennan F, Woodruf J, Burt M (1993) Parathyroid carcinoma: Diagnosis and clinical history. Surgery 114:882–892
Makeown PP, McGarity WC, Sewell CW (1984) Carcinoma of parathyroid gland: Is it overdiagnosed? A report of three cases. Am J Surg 147:292–298
August DA, Flynn SD, Jones MA, Bagwell CB, Kinder B (1993) Parathyroid carcinoma: The relationship of nuclear DNA content to clinical outcome. Surgery 113:290–296
Berland Y, Olmer M, Lebreuil G, Grisoli J (1982) Parathyroid carcinoma, adenoma and hyperplasia in a case of chronic renal insufficiency on dialysis. Clin Neprol 18:154–158
Sherlock DJ, Newman J, Holl-Allen RTJ (1985) Parathyroid carcinoma presenting as tertiary hyperparathyroidism. Postgrad Med J 61:243–244
Ireland JP, Fleming SJ, Levison DA, Cattel WR, Baker LRI (1985) Parathyroid carcinoma associated with chronic renal failure and previous radiotherapy to the neck. J Clin Pathol 38:1114–1118
Krishna GG, Mendez M, Levy B, Ritchie W, Marks A, Narins RG (1989) Parathyroid carcinoma in a chronic hemodialysis patient. Nephron 52:194–195
Rademaker P, Meijer S, Oosterhuis JW, Vermey A, Zwierstra R, Hem G, Geerlings W (1990) Successful surgical treatment of parathyroid carcinoma in two haemodialysis patients. Nephrol Dial Transplant 5:545–548
Iwamoto N, Yamazaki S, Fukuda T, Kondo M, Yamamoto N, Ono T, Hiratake Y, Yasui A (1990) Two cases of parathyroid carcinoma in patients on long-term hemodialysis. Nephron 55:429–431
Tominaga Y, Tanaka Y, Sato K, Numano M, Uchida K, Takagi H (1991) Surgical treatment of secondary hyperparathyroidism. J Bone Miner Metab 9:270–276
Schantz A, Castleman B (1973) Parathyroid carcinoma A study of 70 cases. Cancer 31:600–605
Tominaga Y, Tanaka Y, Sato K, Numano M, Uchida K, Falkmer U, Grimelius L, Johansson H, Takagi H (1992) Recurrent renal hyperparathyroidism and DNA analysis of autografted parathyroid tissue. World J Surg 16:595–603
Falchetti A, Bale AE, Amorosi A, Bordi C, Cicchi P, Brandini S, Marx SJ, Brandi ML (1993) Progression of uremic hyperparathyroidism involves allelic loss on chromosome 11. J Clin Endocrinol Metab 76:139–144
Tominaga Y, Takagi H (1992) Invited commentary. Endo Surg 12:374–375
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Tominaga, Y., Numano, M., Uchida, K. et al. Lung metastasis from parathyroid carcinoma causing recurrent renal hyperparathyroidism in a hemodialysis patient: Report of a case. Surg Today 25, 984–986 (1995). https://doi.org/10.1007/BF00312388
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DOI: https://doi.org/10.1007/BF00312388