Debulking surgery for functional pleural dissemination of parathyroid carcinoma-case report.


Journal

Journal of cardiothoracic surgery
ISSN: 1749-8090
Titre abrégé: J Cardiothorac Surg
Pays: England
ID NLM: 101265113

Informations de publication

Date de publication:
15 Apr 2021
Historique:
received: 29 10 2020
accepted: 05 04 2021
entrez: 16 4 2021
pubmed: 17 4 2021
medline: 23 6 2021
Statut: epublish

Résumé

A rare cause of primary hyperparathyroidism (PHPT) is a parathyroid carcinoma. Hypercalcemia with an elevated parathyroid hormone (PTH) level seen in recurrent and metastasis disease cases is often refractory to medical therapy, thus surgical resection is recommended when possible. We performed debulking surgery for pleural dissemination of parathyroid cancer for improvement of symptoms in a patient with hypercalcemia. A 30-year-old male with hypercalcemia was diagnosed with parathyroid cancer. Following surgery, intact PTH level elevation and hypercalcemia progression due to recurrent disease were noted. An active status of functional left pleural dissemination was revealed in 99mTc-methoxyisobutylisonitrile and somatostatin receptor scintigraphy results, but not in the area of pulmonary metastasis, and debulking surgery was performed. Thereafter, the PTH level was decreased temporarily and activities of daily living improved. Aggressive resection of metastatic disease in patients with a parathyroid carcinoma is taken into consideration to control hypercalcemia.

Sections du résumé

BACKGROUND BACKGROUND
A rare cause of primary hyperparathyroidism (PHPT) is a parathyroid carcinoma. Hypercalcemia with an elevated parathyroid hormone (PTH) level seen in recurrent and metastasis disease cases is often refractory to medical therapy, thus surgical resection is recommended when possible. We performed debulking surgery for pleural dissemination of parathyroid cancer for improvement of symptoms in a patient with hypercalcemia.
CASE PRESENTATION METHODS
A 30-year-old male with hypercalcemia was diagnosed with parathyroid cancer. Following surgery, intact PTH level elevation and hypercalcemia progression due to recurrent disease were noted. An active status of functional left pleural dissemination was revealed in 99mTc-methoxyisobutylisonitrile and somatostatin receptor scintigraphy results, but not in the area of pulmonary metastasis, and debulking surgery was performed. Thereafter, the PTH level was decreased temporarily and activities of daily living improved.
CONCLUSION CONCLUSIONS
Aggressive resection of metastatic disease in patients with a parathyroid carcinoma is taken into consideration to control hypercalcemia.

Identifiants

pubmed: 33858470
doi: 10.1186/s13019-021-01477-z
pii: 10.1186/s13019-021-01477-z
pmc: PMC8048281
doi:

Substances chimiques

Parathyroid Hormone 0
Calcium SY7Q814VUP

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

86

Références

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pubmed: 31336364
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pubmed: 22751344
J Korean Surg Soc. 2012 Jun;82(6):385-8
pubmed: 22708102

Auteurs

Sachi Kawagishi (S)

Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2-L5, Yamadaoka, Suita, 565-0871, Osaka, Japan.

Soichiro Funaki (S)

Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2-L5, Yamadaoka, Suita, 565-0871, Osaka, Japan.

Naoko Ose (N)

Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2-L5, Yamadaoka, Suita, 565-0871, Osaka, Japan.

Kenji Kimura (K)

Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2-L5, Yamadaoka, Suita, 565-0871, Osaka, Japan.

Kosuke Mukai (K)

Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.

Michio Otsuki (M)

Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.

Yasushi Shintani (Y)

Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, 2-2-L5, Yamadaoka, Suita, 565-0871, Osaka, Japan. yshintani@thoracic.med.osaka-u.ac.jp.

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Classifications MeSH