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2010 | 5 | 1 | 53-58
Tytuł artykułu

A complex case of Multiple Endocrine Neoplasia type 1 with Metastatic Parathyroid Carcinoma

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Języki publikacji
EN
Abstrakty
EN
We describe below a patient with Multiple Endocrine Neoplasia type 1 (MEN type 1) who presented with features of Primary Hyperparathyroidism. However, the actual diagnosis of Parathyroid Carcinoma was delayed until metastases to the lung were discovered. She was also found to have Pituitary Macro adenoma with Silent Acromegaly, with no clinical features whatsoever. She underwent transphenoidal hypophysectomy with postoperative radiotherapy. However, the disease process remained biochemically active necessitating commencement of somatostatin analogues. There is also a tumour at the head of the pancreas which at present is non functional with normal gut hormone profile and normal 24 hour urinary 5-hydroxyl indole acetic acid (5-HIAA) excretion assay. Our case highlights the pitfalls in diagnosing the parathyroid carcinoma due to lack of initial proper histological features. The diagnosis of parathyroid carcinoma was based on histologically confirmed metastases to the lungs. We also discuss below the entity called Silent Acromegaly where patients have biochemically and/or histologically confirmed growth Hormone (GH) excess with no clinical features suggesting Acromegaly. We discuss the benefits of somatostatin analogues in indirectly controlling the rest of the tumours in MEN1 and hypothesise the same for metastatic parathyroid carcinoma. Metastatic parathyroid carcinoma with multiple endocrine neoplasia type 1 is extremely rare. Our case highlights the complexities of managing MEN1 with metastatic parathyroid carcinoma and the dilemmas in dealing with the various aspects of the care.
Wydawca
Czasopismo
Rocznik
Tom
5
Numer
1
Strony
53-58
Opis fizyczny
Daty
wydano
2010-02-01
online
2010-01-29
Twórcy
  • Department of Endocrinology, Royal Albert Edward Infirmary, WN1 2NN, Wigan, UK
  • Department of Endocrinology, Royal Albert Edward Infirmary, WN1 2NN, Wigan, UK , Indratala@aol.com
autor
  • Department of Endocrinology, Royal Albert Edward Infirmary, WN1 2NN, Wigan, UK
Bibliografia
  • [1] Obara T., Fujimoto Y., Diagnosis and treatment of patients with parathyroid carcinoma: an update and review, World J Surg., 1991,15(6), 738–744 http://dx.doi.org/10.1007/BF01665308[Crossref]
  • [2] Dionisi S., Minisola S., Pepe J., et al., Concurrent parathyroid adenomas and carcinoma in the setting of multiple endocrine neoplasia type 1: presentation as hypercalcemic crisis, Mayo Clin Proc., 2002, 77(8), 866–869 http://dx.doi.org/10.4065/77.8.866[Crossref]
  • [3] Agha A., Carpenter R., Bhattacharya S., J Monson JP., Parathyroid carcinoma in multiple endocrine neoplasia (MEN) type 1: two case reports - poster presentation, Endocrine Abstracts., 2006, 11, P106
  • [4] Schantz A., Castleman B., Parathyroid carcinoma. A study of 70 cases, Cancer., 1973, 31, 600 http://dx.doi.org/10.1002/1097-0142(197303)31:3<600::AID-CNCR2820310316>3.0.CO;2-0[Crossref]
  • [5] Bondeson L., Sandelin K., Grimelius L., Histopathological variables and DNA cytometry in parathyroid carcinoma, Am J Surg Pathol., 1993, 17(8), 820–829 http://dx.doi.org/10.1097/00000478-199308000-00007[Crossref]
  • [6] El-Hajj G., Arnold A., Parathyroid carcinoma, Uptodate Medicine, 2008
  • [7] Wassif W.S., Moniz C.F., Friedman E., Wong S., Weber G., Nordenskjold M., Peters T.J., Larsson C., Familial isolated hyperparathyroidism: A distinct genetic entity with an increased risk of parathyroid cancer., J. Clin. Endocrinol. Metab., 1993, 77, 1485–1489 http://dx.doi.org/10.1210/jc.77.6.1485[Crossref]
  • [8] Fraker DL., Parathyroid Tumour. In: DeVita VT Jr, Hellman S, Rosenberg SA., Cancer: Principles and Practice of Oncology. 7th ed. Philadelphia, Pa: Lippincott Williams & Wilkins., 2005, 1521–1527
  • [9] Shane E., Clinical review 122: Parathyroid carcinoma, J Clin Endocrinol Metab., 2001, 86(2): 485–493 http://dx.doi.org/10.1210/jc.86.2.485[Crossref]
  • [10] Sieracki J.C., and Horn R.C, Jr., Nonfunctional carcinoma of the parathyroid gland, Cancer., 1960, 13, 502–506 http://dx.doi.org/10.1002/1097-0142(196005/06)13:3<502::AID-CNCR2820130312>3.0.CO;2-R[Crossref]
  • [11] Aldinger K.A., Hickey R.C., Ibanez M.L., and Samaan N.A., Parathyroid carcinoma: A clinical study of seven cases of functioning and two cases of nonfunctioning parathyroid cancer, Cancer., 1982, 49, 388–397 http://dx.doi.org/10.1002/1097-0142(19820115)49:2<388::AID-CNCR2820490230>3.0.CO;2-F[Crossref]
  • [12] Eurelings M., Frijns C.J.M., Jeurissen F.J.F., Painful ophthalmoplegia from metastatic nonproducing parathyroid carcinoma: Case study and review of the literature, Neuro-oncol., 2002, 4(1), 44–48 http://dx.doi.org/10.1215/15228517-4-1-44[Crossref]
  • [13] Kebebew E., Parathyroid carcinoma, Curr Treat Options Oncol., 2001, 2, 347–354 http://dx.doi.org/10.1007/s11864-001-0028-2[Crossref]
  • [14] Kebebew E., Arici C., Duh QY., Clark OH., Localization and reoperation results for persistent and recurrent parathyroid carcinoma, Arch Surg., 136, 878–885
  • [15] Collins MT., Skarulis MC., Bilezikian JP., Silverberg SJ., Spiegel AM., Marx SJ., Treatment of hypercalcemia secondary to parathyroid carcinoma with a novel calcimimetic agent, J Clin Endocrinol Metab., 1998, 83, 1083–1088 http://dx.doi.org/10.1210/jc.83.4.1083[Crossref]
  • [16] Bradwell AR., Harvey TC., Control of hypercalcaemia of parathyroid carcinoma by immunisation, Lancet., 1999, 353, 370–373 http://dx.doi.org/10.1016/S0140-6736(98)06469-1[Crossref]
  • [17] Betea D., Bradwell AR., Harvey TC., Mead GP., Schmidt-Gayk H., Ghaye B., Daly AF., Beckers A., 2004 Hormonal and biochemical normalization and tumour shrinkage induced by anti-parathyroid hormone immunotherapy in a patient with metastatic parathyroid carcinoma, J. Clin Endocrinol Metab., 2004, 89, 3413–3420 http://dx.doi.org/10.1210/jc.2003-031911[Crossref]
  • [18] Marx S., Spiegel AM., Skarulis MC., Doppman JL., Collins FS., Liotta LA., Multiple endocrine neoplasia type 1: clinical and genetic topics, Ann Intern Med., 1998, 129(6), 484–94
  • [19] Baris D., Gridley G., Ron E, Weiderpass E., Mellemkjaer L., Ekbom A., Olsen JH., Baron JA., Fraumeni JF Jr., Acromegaly and cancer risk: a cohort study in Sweden and Denmark, Cancer Causes Control., 2002, 13(5), 395–400 http://dx.doi.org/10.1023/A:1015713732717[Crossref]
  • [20] White H.D., Ahmad A.M., Durham B.H., Chandran S., Patwala A., Fraser W.D., and Vora J.P., Effect of Active Acromegaly and Its Treatment on Parathyroid Circadian Rhythmicity and Parathyroid Target-Organ Sensitivity, J. Clin. Endocrinol. Metab., 2006, 91, 913–919 http://dx.doi.org/10.1210/jc.2005-1602[Crossref]
  • [21] Orme S.M., McNally R.J.Q., Cartwright R.A., Belchetz P.E., Mortality and Cancer Incidence in Acromegaly: A Retrospective Cohort Study, J. Clin. Endocrinol. Metab., 1998, 83, 2730–2734 http://dx.doi.org/10.1210/jc.83.8.2730[Crossref]
  • [22] Utiger R. D., Treatment of Acromegaly, N Engl J Med., 2000, 342,1210–1211 http://dx.doi.org/10.1056/NEJM200004203421611[Crossref]
  • [23] S Yamada S., T Sano T., L Stefaneanu L., K Kovacs K., T Aiba T., S Sawano S., Shishiba Y., Endocrine and morphological study of a clinically silent somatotroph adenoma of the human pituitary, J. Clin. Endocrinol. Metab., 1993, 76, 352–356 http://dx.doi.org/10.1210/jc.76.2.352[Crossref]
  • [24] Sakharova A.A., Dimaraki E.V., Chandler W.F., Barkan A.L., Clinically Silent Somatotropinomas May Be Biochemically Active, J. Clin. Endocrinol. Metab., 2005, 90, 2117–2121 http://dx.doi.org/10.1210/jc.2004-0875[Crossref]
  • [25] Yamada S., Sano T., Stefaneanu L., Kovacs K., Aiba T., Sawano S., Shishiba Y., Endocrine and morphological study of a clinically silent somatotroph adenoma of the human pituitary, J Clin Endocrinol Metab., 1993, 76, 352–356 http://dx.doi.org/10.1210/jc.76.2.352[Crossref]
  • [26] Klibanski A., Zervas N.T., Kovacs K., Ridgway E.C., Clinically silent hypersecretion of growth hormone in patients with pituitary tumours, J Neurosurg., 1987, 66, 806–811 http://dx.doi.org/10.3171/jns.1987.66.6.0806[Crossref]
  • [27] Kalavalapalli S., Reid H, Kane J., Buckler H., Trainer P., Heald AH., Silent growth hormone secreting pituitary adenomas. IGF-1 is not sufficient to exclude growth hormone excess, Ann. Of Cli. Biochem., 2007, 44, 89–93 http://dx.doi.org/10.1258/000456307779596075[WoS]
Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.-psjd-doi-10_2478_s11536-009-0116-4
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