Parathyroid carcinoma occurring in multiple endocrine neoplasia type 1.

Kodroff KS, Lieber C, Thompson LDR.
Endocr Pract. 1999 Nov-Dec;5(6):347-349.
OBJECTIVE: To describe a patient with multiple endocrine neoplasia type I (MEN-I) in whom parathyroid carcinoma developed.
METHODS: A case report is presented, including detailed history, laboratory findings, and pathologic features.
RESULTS: A 49-year-old man with a known history of MEN-I syndrome had hypercalcemia and profoundly increased parathyroid hormone levels. Seven years earlier, he had been diagnosed with a gastrinoma, prolactinoma, and primary hyperparathyroidism. A neck exploration at that time consisted of resection of a right inferior parathyroid gland and parathyroid tissue in the thyroid gland as well as biopsies of two left-sided glands, after which microscopic examination revealed parathyroid hyperplasia and his serum calcium levels normalized. On reexploration of the neck, resection revealed pathologic findings consistent with parathyroid carcinoma.
CONCLUSION: Parathyroid carcinoma has rarely been reported in the setting of MEN-I. This case illustrates the need for near-complete resection of parathyroid tissue in the patient with MEN-I. Subtotal or total parathyroidectomy in conjunction with forearm autotransplantation should be performed, not simply to prevent recurrence of benign disease but also to prevent the potential development of carcinoma over time.
PubMed ID: n/a
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