부산대학교 도서관

Parathyroid carcinoma is a rare endocrine neoplasm and a rare cause of primary hyperparathyroidism. The majority of cases of parathyroid carcinoma manifest as sporadic forms, but familial cases have been reported. In most cases, parathyroid carcinoma is associated with hypersecretion of parathyroid hormone and marked hypercalcemia. Diagnosing parathyroid carcinoma can be difficult because clinical features, biochemical, and imaging studies often overlap with benign parathyroid disease. Usually, parathyroid carcinoma is confirmed by histopathological examination postoperatively. Surgical resection remains a mainstay of treatment and is the most effective therapy to control cancer-related hypercalcemia. We report the case of a 36-year-old man who presented with left lower leg numbness, pain radiating to the left thigh and knee, and bilateral buttock pain for three months. Fifth lumbar and first sacral intervertebral disc herniation was diagnosed by an orthopedist, and he was then hospitalized for a scheduled discectomy. During the preoperative workup, impaired renal function was noted, with elevated creatinine level and decreased estimated glomerular filtration rate. After scheduled discectomy, investigation of impaired renal function disclosed nephrocalcinosis via renal ultrasonography. Hyperparathyroidism, severe hypercalcemia with overt clinical manifestations, and a right lower parathyroid mass were further discovered. Patient received parathyroidectomy and parathyroid carcinoma was diagnosed by histopathological examination. Reoperation with ipsilateral thyroidectomy and central cervical lymph node dissection was performed. Long-term follow up is necessary due to the high recurrence rate.