A Case of Persistent Primary Hyperparathyroidism Caused by Parathyroid Carcinoma Recurred Along Esophagus / 대한내분비외과학회지

ABSTRACT

Primary hyperparathyroidism is most commonly caused by an adenoma but rarely by carcinoma of the parathyroid gland. The common clinical manifestations were bone pain, recurrent urinary stone and asymptomatic. Parathyroid carcinoma is different from the parathyroid adenoma in that the invasion to the surrounding tissue or metastasis to the regional lymph nodes and persistent hyperparathyroidism are common in parathyroid carcinoma. It is important that radical en-bloc resection of parathyroidal mass including the lobe of the thyroid that is on the same side and post op follow up is important as well. There is the need of radical surgery even in recurrence of metastatic parathyroid carcinoma for improving hypercalcemia. We experienced a 50-year-old man with primary hyperparathyroidism caused by a parathyroid carcinoma in the left lower parathyroid which was confirmed by histopathologic findings. He was cured by using en-bloc resection of the parathyroid including the left lobe of the thyroid and a left side modifed radical neck dissection. But after 2 months hypercalcemia occurred again and therefore examination with computed tomography, endoscopic ultrasonography and esophagogram revealed a metastasis to the upper and mid esophagus. We opened the chest cavity and resected the surrounding mass of the esophagus. the mass was confirmed to be metastatic tissue from parathyroid carcinoma by histopathologic finding. therefore we report this case.