No abstract available.
Parathyroid Neoplasms*

We report a case of diabetes mellitus in a middle-aged female who subsequently developed primary hyperparathyroidism and underwent parathyroidectomy. Prior to surgery, she was hospitalized several times since 1988 for vomiting, pain abdomen and dehydration. On none of these occasions hypercalcaemia could be documented. Yet she developed pancreatic calcification and diabetes in 1991 and was diagnosed as fibrocalculous pancreatic diabetes (FCPD) and treated with insulin. Nephrolithiasis developed in 2003. Hypercalcaemia with high PTH was detected in 2004 and a solitary right parathyroid adenoma was identified and surgically removed. Following surgery, gastrointestinal symptoms disappeared but diabetes remained unaltered on follow up for 8 years. The cause of multi-organ calcification which started well before development of hypercalcaemia is not known.
Parathyroid Neoplasms

Background: Parathyroid carcinoma is an uncommon, aggressive, endocrine malignant neoplasm and subsequent parathyroidectomy of such cases may lead to the life-threatening hypocalcemic condition called Hungry Bone Syndrome. We present a very rare case of parathyroid carcinoma with concomitant thyroid microcarcinoma with Hungry Bone Syndrome as its sequalae. Case Presentation: A 54/F initially presenting with hypogastric pain was showed to have nephrolithiasis. Subsequent Endocrinology referral revealed hypercalcemia and osteoporosis – and with a working impression of hypercalcemia secondary to a parathyroid adenoma. Sestamibi parathyroid scan showed persistently avid uptake in the left thyroid lobe highly suspicious for a parathyroid adenoma, but a concomitant thyroid nodule was not ruled out. Bone scan showed intense and diffuse tracer uptake in the skull and irregular tracer activity in the ribs, suggestive of metabolic bone disease, with no evidence of metastatic-looking bone lesions. She underwent left thyroid lobectomy with isthmusectomy and Sestamibi-guided left parathyroidectomy. Histopathology report showed a parathyroid gland carcinoma with papillary thyroid microcarcinoma. Two weeks post-surgery, hypocalcemic signs developed and ionized calcium was low. Hungry Bone Syndrome was considered and was treated with calcium gluconate and Zoledronic acid. Conclusion Nuclear imaging techniques and radioguided surgery are helpful in the diagnosis and management of both parathyroid and thyroid lesions – especially in difficult cases.
Parathyroid Neoplasms

No abstract available.
Parathyroid Neoplasms*

Co-existence of multiple pathologies affecting a patient poses a challenge in the diagnosis and management. A rare combination of early tongue cancer, maxillary fungal rhinosinusitis, calcified thyroid nodule and primary hyperparathyroidism in a 70-year-old female is described. The evidences used for disease probabilities based on diagnostic results and effectivess of treatment modalities are presented. The decision-making process to come up with an individualized management is discussed.

No abstract available.
Hyperparathyroidism, Primary* ; Parathyroid Neoplasms*

No abstract available.
Hyperparathyroidism, Primary ; Parathyroid Neoplasms

No abstract available.
Hyperparathyroidism, Primary ; Parathyroid Neoplasms

No abstract available.
Pancreatitis* ; Parathyroid Neoplasms*

We report the case of a 19-year old Filipino woman who presented with hard masses on the left upper arm and leg with multiple fractures on all extremities. Her serum calcium and intact parathyroid hormone (iPTH) levels were elevated, while serum phosphorus was low. Ultrasonography of the neck revealed a left inferior parathyroid mass. Ultrasound-guided fine needle aspiration of the mass revealed findings consistent with parathyroid carcinoma. After hydration and administration of diuretic and bisphosphonate to control the severe hypercalcemia, she subsequently underwent 3½ gland parathyroidectomy with en-bloc left thyroid lobectomy. There was immediate normalization of biochemical indices after surgery. Three months later, the fractures on all extremities were fully resolved.
Hypercalcemia ; Hyperparathyroidism ; Parathyroid Neoplasms