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World Journal of Clinical Cases 2014年第5期2卷 151-156页

作者： Maja Baretic Hrvojka Tomic Brzac margareta dobrenic Antonia Jakovcevic Division of Endocrinology Department of Internal MedicineUniversity Hospital Centre Zagreb10000 ZagrebCroatia Clinical Department of Nuclear Medicine and Radiation Protection University Hospital Centre Zagreb10000 ZagrebCroatia Department of Pathology and Cytology University Hospital Centre Zagreb10000 ZagrebCroatia

A 24-year-old female patient with parathyroid carcinoma,the rarest endocrine malignancy,had two *** the first pregnancy,she had severe nausea and *** and hyperparathyroidism were diagnosed in the postpartum *** gravidarum masked a diagnosis of *** ultrasound and Tc-99 m sestamibi found an enlarged lower right parathyroid *** gland was surgically removed,and an initial pathology report described atypical *** afterward,she became pregnant *** the second pregnancy,her calcium level was frequently controlled but was always in the normal *** is explained by the specific physiology of pregnancy accompanied by hemodilution,hypoalbuminemia and maternal hypercalciuria(mediated by increased glomerular filtration).During lactation,calcium levels rose,and a newneck ultrasound showed a solitary mass in the area of prior surgery and an enlarged pretracheal lymph *** needle aspiration of the solitary mass and node showed parathyroid carcinoma *** tumor mass was resected en bloc with the contiguous tissues and surrounding lymph nodes(pathology report; parathyroid carcinoma with metastases).Over the next five years,four consecutive surgeries were performed to remove malignant parathyroid tissue,lymph nodes and local *** the surgical procedures,no hypocalcemia was *** serious hypercalcemia recurred; the calcium level was difficult to control with a combination of pamidronate,cinacalcet and loop *** elements of multiple endocrine neoplasia were present.

关键词： Parathyroid carcinoma Hypercalcemia Hyperparathyroidism Pregnancy Hyperemesis gravidarum

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