Primary hyperparathyroidism in breast cancer

ABSTRACT

The coexistence of primary hyperparathyroidism and breast cancer is herein reported to emphasize the proper work-up for patients with hypercalcaemia. We present the clinical, laboratory', radiological and pathology findings and describe the clinical course of the patient. A 49-year-old Arab female with a recent diagnosis of right breast cancer was evaluated because of persistent hypercalcaemia despite repealed intravenous pamidronate treatment. Evaluation revealed hypercalcaemia with elevated intact parathyroid hormone [PTH].Parathyroid scan and neck ultrasound were suggestive of double parathyroid adenomas. The patient underwent resection of the right lower and left upper parathyroid glands. Three months later, she remained hypercalcaemic with high intact parathyroid hormone level. Primary hyperparathyroidism and breast cancer may possibly coexist. Therefore PTH level must be checked in the evaluation of hypercalcaemia in breast cancer patients. Neck exploration is superior to imaging in localising the "anatomic" aetiology of hyperparathyroidism