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Erschienen in: Endocrine 2/2020

04.04.2020 | Endocrine Surgery

Intrapericardial parathyroid carcinoma: a case report

verfasst von: Yunhui Xin, Teng Zhao, Bojun Wei, Hua Gu, Mulan Jin, Hong Shen, Xing Liu, Jiacheng Wang, Qian Wang

Erschienen in: Endocrine | Ausgabe 2/2020

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Abstract

Purpose

Ectopic parathyroid glands are thought to be the cause of a significant portion of failed primary surgery for hyperparathyroidism. Parathyroid carcinoma (PTCA) is a rare malignant tumor, and ectopic PTCA is a particularly unusual situation. Here, we describe, for the first time, a case of intrapericardial PTCA.

Methods

We describe the case of a 53-year-old female presented with 1-year history of backache, multiple fractures, nephrolithiasis, nausea, vomiting, fatigue, and unexplained myocardial ischemia-like symptoms. Physical examination revealed a barrel chest and sternal tenderness with stable vital signs. Blood tests confirmed hypercalcemia (3.70 mmol/L) and hyperparathyroidism (>1900 pg/ml). 99mTc-sestamibi scan indicated ectopic findings in the mediastinum highly suggestive of parathyroid adenoma.

Results

After more tests, cardiac magnetic resonance imaging (MRI) revealed a mass closely related to the great vessels of the heart. The ectopic tumor in the pericardium was successfully resected through sternotomy, with subsequent histopathological confirmation of PTCA. The metabolism of calcium and phosphorus and the level of PTH returned to normal after surgery.

Conclusion

This unique case reinforces the tremendous variety of possible ectopic locations of parathyroid glands. Although most patients with primary hyperparathyroidism (PHPT) carry a high suspicion of a benign course, the entity of ectopic PTCA also needs to be considered. Accurate preoperative locating diagnosis as well as en bloc tumor resection offers the highest chance of cure in patients with PHPT.
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Metadaten
Titel
Intrapericardial parathyroid carcinoma: a case report
verfasst von
Yunhui Xin
Teng Zhao
Bojun Wei
Hua Gu
Mulan Jin
Hong Shen
Xing Liu
Jiacheng Wang
Qian Wang
Publikationsdatum
04.04.2020
Verlag
Springer US
Erschienen in
Endocrine / Ausgabe 2/2020
Print ISSN: 1355-008X
Elektronische ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-020-02283-8

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