Answer 1
A 45-year-old woman presented with severe back pain. After radiological and physical examination, the patient was found to have nephrolithiasis with marked hypercalcemia. In addition, a palpable mass in the right side of the neck was encountered. Surgical resection of the mass was performed.
C. Parathormone (PTH)
Answer 2
D. Parathyroid carcinoma
Comment
Parathyroid carcinomas are unusual tumors. The tumor appears to affect adult men and women almost in equal proportions.
Clinically, the presence of marked hypercalcemia appears to be a common denominator for these tumors. Since parathyroid adenoma may also present with similar symptomatology, the distinction between adenoma and carcinoma is essentially a histological diagnosis.
The treatment of choice for patients with parathyroid carcinomas is complete surgical resection. Recurrences of these tumors usually occur within 3 years after initial diagnosis. Metastatic disease can develop to lymph nodes, lung, and liver.
Reference
1. Wang CA, Gaz RD. Natural history of parathyroid carcinoma. Diagnosis, treatment, and results. Am J Surg. 1985;149:522-527.
