Læknablaðið : fylgirit - 01.06.1982, Page 43

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SECONDARY PARATHYROID CARCINOMA WITHOUT HYPERPARATHYROIDISM
Sigurdur T. Gudmundsson, Dept. of Medicine, Landspítalinn
Reykjavik,Iceiand
Lately the diagnosis of hyperparathyroidism has depended on
establishing increased levels of parathyroid hormone and
calcium in the blood stream.
Recognized clinical truths about hyperparathyroidism
associated with parathyroid carcinoma are:
1) It is very rare.
2) Hypercalcemia is a cardinal symptom whether the disease
is primary or secondary.
3) Parathyroid carcinoma grows slowly and metastasizes
mainly locally, and to cervical lymphnodes, lungs,
liver and bone.
4) Cerebral metastases have not been described.
In 1981 two cases of hyperparathyroidism due to para-
thyroid carcinoma were diagnosed in the departments of
medicine and surgery of Landspitalinn. Hypercalcemia heralded
the diagnosis of a relapse of the first case after 4 months.
Removal of a cervical metastasis brought about a remission.
The second case was "cured" biochemically by the removal
of a cancerous parathyroid gland on August 31, 1981. Three
months later a cerebral tumor was partially removed which
turned out to be a metastasis from a parathyroid carcinoma.
Serial measurements of PTH and calcium in serum and CSF
will be discussed.