The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지

A case of ectopic parathyroid carcinoma presenting with renal failure and anemia

신부전과 빈혈로 발현된 이소성 부갑상선암 1예

Kang, Myong-Su;Lee, Ho-Yun;Seo, Pyong-Ju;Kim, Hee-Jin;Yun, Sung-Chul;Seo, Phil-Won;Kwon, Mi-Seon
강명수;이호연;서평주;김희진;윤성철;서필원;권미선

  • Published : 20061000
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Abstract

Parathyroid carcinoma is an uncommon cause of PTH-related hypercalcemia with a reported incidence of 0.4% to 5% of all cases of primary hyperparathyroidism. Even though the clinical manifestations of hyperparathyroidism are more severe in patients with parathyroid carcinoma than in those with parathyroid adenoma, it is difficult to differentiate carcinoma from adenoma preoperatively. Parathyroid carcinomas are usually larger and firmer than parathyroid adenomas and patients with parathyroid carcinoma have a higher incidence of renal dysfunction, bone disease and gastrointestinal symptoms. Anemia is an uncommon clinical feature of parathyroid carcinoma. There have been no prior cases of ectopic parathyroid carcinomas reported to date. In this article, we report the case of a 26-year-old man who developed severe anemia and acute renal failure due to an ectopic parathyroid tumor and was diagnosed with parathyroid carcinoma postoperatively. His serum calcium levels returned to normal and the anemia resolved postoperatively

저자들은 일차성 부갑상선기능항진증으로 인한 고칼슘혈증, 급성신부전, 대사성 골질환 및 심한 빈혈을 보인 환자에서 이소성 종격동 부갑상선암을 절제한 후 고칼슘혈증 뿐 아니라 골수섬유증에 의한 빈혈과 급성신부전도 호전된 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords

References

  1. Busaidy NL, Jimenez C, Habra MA, Schultz PN, El-Naggar AK, Clayman GL, Asper JA, Diaz EM Jr, Evans DB, Gagel RF, Garden A, Hoff AO, Lee JE, Morrison WH, Rosenthal DI, Sherman SI, Sturgis EM, Waguespack SG, Weber RS, Wirfel K, Vassilopoulou-Sellin R. Parathyroid carcinoma: a 22-year experience. Head Neck 26:716-726, 2004 https://doi.org/10.1002/hed.20049
  2. Mittendorf EA, McHenry CR. Parathyroid carcinoma. J Surg Oncol 89:136-142, 2005 https://doi.org/10.1002/jso.20182
  3. DeLellis RA. Parathyroid carcinoma: an overview. Adv Anat Pathol 12:53-61, 2005 https://doi.org/10.1097/01.pap.0000151319.42376.d4
  4. Levin KE, Galante M, Clark OH. Parathyrid carcinoma versus parathyroid adenoma in patients with profound hypercalcemia. Surgery 101:649-660, 1987
  5. Shane E. Clinical review 122: parathyroid carcinoma. J Clin Endocrinol Metab 86:485-493, 2001 https://doi.org/10.1210/jc.86.2.485
  6. Boxer M, Ellman L, Geller R, Wang CA. Anemia in primary hyperparathyroidism. Arch Intern Med 137:588-593, 1977 https://doi.org/10.1001/archinte.137.5.588
  7. 김인철, 박승만, 김영하. 기능성 부갑상선암 1예. 대한외과학회지 32:120-126, 1987
  8. 오승근, 박용현, 김주현, 이명식, 민현기. 다발성 원발성 부갑상선 암종. 대한외과학회지 39:546-553, 1990
  9. 최윤희, 유순집, 한제호, 차봉연, 이광우, 손호영, 강성 구, 원종만, 성미숙, 유진영. 저칼륨혈증을 동반한 부갑 상선기능 항진증을 보인 부갑상선암 1예. 대한내분비학회지 12:81-89, 1997
  10. 김난희, 이정환, 오정헌, 김신곤, 김수미, 신동현, 박이 병, 백세현, 최동섭. $^{99m}Tc$-sestamibi 스캔으로 병소가 확인된 전이성 부갑상선암 1예. 대한내분비학회지 12: 627-632, 1997
  11. Clayman GL, Gonzalez HE, El-Naggar A, Vassilopoulou- Sellin R. Parathyroid carcinoma: evaluation and interdisciplinary managemt. Cancer 100:900-905, 2004 https://doi.org/10.1002/cncr.20089
  12. Obara T, Fujimoto Y. Diagnosis and treatment of patients with parathyroid carcinoma: an update and review. World J Surg 15:738-744, 1991 https://doi.org/10.1007/BF01665308
  13. Hundahl SA, Fleming ID, Fremgen AM, Menck HR. Two hundred eighty-six cases of parathyroid carcinoma treated in the U.S. between 1985-1995: a National Cancer Data Base Report. Cancer 86:538-544, 1999 https://doi.org/10.1002/(SICI)1097-0142(19990801)86:3<538::AID-CNCR25>3.0.CO;2-K
  14. 정형근, 김덕윤, 우정택, 김성운, 양인명, 김진우, 김영 설, 김광원, 최영길. 원발성 부갑상선기능 항진증의 임 상적 특성-최근 경험 17예를 포함한 국내 문헌 고찰. 대한내분비학회지 7:234-242, 1992
  15. 이기문, 노동영, 최국진, 윤여규, 오승근. 원발성 부갑상 선 기능 항진증. 대한외과학회지 60:273-280, 2001
  16. Phitayakorn R, McHenry CR. Incidence and location of ectopic abnormal parathyroid glands. Am J Surg 191:418-423, 2006 https://doi.org/10.1016/j.amjsurg.2005.10.049
  17. Koea JB, Shaw JH. Parathyroid cancer: biology and management. Surg Oncol 8:155-165, 1999 https://doi.org/10.1016/S0960-7404(99)00037-7
  18. Castelli I, Steiner LA, Kaufmann MA, Drop LJ. Renovascular responses to high and low perfusate calcium steady-state experiments in the isolated perfused rat kidney with baseline vascular tone. J Surg Res 61:51-57, 1996 https://doi.org/10.1006/jsre.1996.0080
  19. Sikole A. Pathogenesis of anaemia in hyperparathyroidism. Med Hypotheses 54:236-238, 2000 https://doi.org/10.1054/mehy.1999.0027
  20. Brancaccio D, Cozzolino M, Gallieni M. Hyperparathyroidism and anemia in uremic subjects: a combined therapeutic approach. J Am Soc Nephrol 15:S21-S24, 2004 https://doi.org/10.1097/01.ASN.0000093369.09194.12