Korean J Med.  2008 Jul;75(1):122-127.

A case of parathyroid carcinoma with acute renal failure and microscopic nephrocalcinosis

• Choi YJ
• An WS
• Kang DY
• Rha SH
• Kim SE
• Kim DK
• Kim KH

Abstract

Parathyroid carcinoma is a very rare disease in patients with primary hyperparathyroidism. Renal impairment and bone disease in the case of parathyroid carcinoma is common due to hypercalcemia. Renal diseases, including nephrocalcinosis, nephrolithiasis, and renal failure are frequent compared with those of benign parathyroid tumors. Nephrocalcinosis is a disorder of increased calcium content and deposition within renal parenchyma. Most cases reporting parathyroid carcinoma have shown medullary calcinosis on radiologic images, but there has been no definitive report of microscopic nephrocalcinosis which does not have a positive radiologic finding. In the case reported herein, a 50-year-old woman had experienced general weakness and a decline in vision. She had hypercalcemia and acute renal failure and the renal biopsy revealed nephrocalcinosis. The PTH level was elevated (940.47 pg/mL) and the parathyroid tumor was localized based on several radiologic findings. Capsular invasion was noted at the time right parathyroidectomy, indicative of parathyroid carcinoma, thus we carried out ipsilateral thyroidectomy. Hypercalcemia was improved after surgery, but renal function was not improved completely due to microscopic nephrocalcinosis.

Keyword

Parathyroid carcinoma; Microscopic nephrocalcinosis; Acute renal failure; Hypercalcemia

MeSH Terms

Acute Kidney Injury
Biopsy
Bone Diseases
Calcinosis
Calcium
Female
Humans
Hypercalcemia
Hyperparathyroidism, Primary
Middle Aged
Nephrocalcinosis
Nephrolithiasis
Parathyroid Neoplasms
Parathyroidectomy
Rare Diseases
Renal Insufficiency
Thyroidectomy
Vision, Ocular
Calcium