Maintenance hemodialysis complicated with lung-metastatic parathyroid carcinoma: a case report and literature review
10.3760/cma.j.cn441217-20230202-00201
- VernacularTitle:维持性血液透析患者合并肺转移性甲状旁腺癌1例并文献复习
- Author:
Xiaoyan CHANG
1
;
Shuwang GE
Author Information
1. 华中科技大学同济医学院附属同济医院肾内科，武汉 430030
- Keywords:
Parathyroid neoplasms;
Hyperparathyroidism;
Renal dialysis;
Lung;
Parathyroid hormone
- From:
Chinese Journal of Nephrology
2023;39(12):932-935
- CountryChina
- Language:Chinese
-
Abstract:
Parathyroid carcinoma (PC) is a rare endocrine malignancy. We report a case of lung metastases of PC in a maintenance hemodialysis patient with renal allograft loss and review the relevant literature. The patient developed hyperparathyroid hormone and hypercalcemia 4 years after hemodialysis treatment. CT examination showed that a round-shaped, soft tissue density shadow without typical enhancement was located in infero-posterior left lobe of thyroid gland. Dual-phase 99mTc-MIBI parathyroid imaging showed abnormal 99mTc-MIBI uptake behind the left lobe of the thyroid gland on both early and delayed imaging. The patient underwent subtotal parathyroidectomy under general anesthesia. Histopathological diagnosis was parathyroid adenoma and parathyroid hyperplasia. The serum parathyroid hormone decreased significantly, but remained above normal, and the serum calcium returned to normal range after the surgery. However, the parathyroid hormone level gradually increased several months after the surgery. 99mTc-MIBI parathyroid imaging showed multiple low-density nodules with increased uptake of 99mTc-MIBI in superior lobe of both lungs one year after the surgery. Ultimately, pulmonary metastasis of PC was confirmed by pathological examination.
