Hypercalcemia caused by ectopic production of parathyroid hormone in a patient with papillary adenocarcinoma of the thyroid gland

Hypercalcemia and elevation of a serum PTH level (9800 pg/mL (normal: 160-520) were found in a 72-yr-old woman who had a lung cancer. She underwent pulmonary lobectomy for a suspected PTH-producing lung cancer. However, hypercalcemia and elevation of the serum PTH level were persistent postoperative...

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Bibliographic Details
Published in:The journal of clinical endocrinology and metabolism 1998-08, Vol.83 (8), p.2653-2657
Main Authors: IGUCHI, H, MIYAGI, C, TOMITA, K, KAWAUCHI, S, NOZUKA, Y, TSUNEYOSHI, M, WAKASUGI, H
Format: Article
Language:English
Subjects:
Adenocarcinoma, Papillary - diagnosis
Adenocarcinoma, Papillary - secretion
Adenocarcinoma, Papillary - surgery
Aged
Biological and medical sciences
Endocrinopathies
Female
Humans
Hypercalcemia - etiology
Lung Neoplasms - complications
Lung Neoplasms - surgery
Malignant tumors
Medical sciences
Paraneoplastic Endocrine Syndromes - complications
Paraneoplastic Endocrine Syndromes - diagnosis
Paraneoplastic Endocrine Syndromes - pathology
Parathyroid Hormone - biosynthesis
Parathyroid Hormone - secretion
Thyroid Neoplasms - diagnosis
Thyroid Neoplasms - secretion
Thyroid Neoplasms - surgery
Thyroid. Thyroid axis (diseases)
Tomography, X-Ray Computed
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Summary:Hypercalcemia and elevation of a serum PTH level (9800 pg/mL (normal: 160-520) were found in a 72-yr-old woman who had a lung cancer. She underwent pulmonary lobectomy for a suspected PTH-producing lung cancer. However, hypercalcemia and elevation of the serum PTH level were persistent postoperatively. Subsequent examination, using parathyroid scintiscanning, revealed a hot spot in the right lower part of the thyroid gland, suggesting hypercalcemia caused by a parathyroid tumor. She underwent bilateral exploration of the neck; however, four apparently normal parathyroid glands were seen. Therefore, hemithyroidectomy was performed for the possibility of an intrathyroidal parathyroid adenoma. Serum calcium and PTH levels declined after this operation. A nodular lesion was found in the cut sections of the resected specimen, which was consistent with the result of the scintiscanning. Histological examinations revealed a papillary adenocarcinoma of the thyroid gland, and the PTH-immunoreactivity in the tumor cells was confirmed. These findings strongly suggest that PTH could be produced ectopically by the papillary adenocarcinoma of the thyroid gland.
ISSN:0021-972X
1945-7197
DOI:10.1210/jc.83.8.2653