Parathyroid carcinoma in an adolescent

✍ Scribed by Toledano, Stuart

• Publisher: John Wiley and Sons
• Year: 1979
• Tongue: English
• Weight: 389 KB
• Volume: 7
• Category: Article
• ISSN: 0098-1532
• DOI: 10.1002/mpo.2950070113

✦ Synopsis

The patient is a 19.year-old white female, who was well until 3 months prior to admission when she fell while roller skating and injured her left arm. X-rays demonstrated a fracture through a bone cyst in the left humerus, and her arm was placed in a sling for several weeks. Healing did not occur and she was admitted to another institution where bone chips from the right iliac crest were placed in the left humeral lesion. Her postoperative course was complicated by persistent emesis, 5 to 6 times per day. After 2 weeks of frequent vomiting unresponsive to antiemetics, her physician ordered a chemical screening profile, at which time a calcium level of 18.5 mg/dl, phosphorus of 1.8 mg/dl, and alkaline phosphatase of 57 IU were discovered. She was then referred to the Children's Hospital of Philadelphia. Initial attempt at reduction of the serum calcium with furosemide and saline diuresis was unsuccessful, and she was given calcitonin with only a very transient response. Finally, mithramycin stabilized her calcium in the 13-14 mg/dl range, and it was at this point that the surgeons were consulted.