Parathyroid carcinoma presenting with ventricular bigeminy in pregnancy

Parathyroid carcinoma is very rare in pregnancy. Clinical features are similar to primary hyperparathyroidism. A 38-year-old pregnant woman had repeated hospital admissions for palpitations, headaches, dizziness and polydipsia. Blood investigations showed severe hypercalcaemia with raised parathyroi...

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Bibliographic Details
Published in:BMJ case reports 2022-02, Vol.15 (2), p.e247069
Main Authors: Gumber, Leher, Sivasankaran, Karthikeyan, Khan, Sardar Mohammad Shoaib
Format: Article
Language:English
Subjects:
Adult
Cancer
Cardiac arrhythmia
Case reports
Case Reports: Rare disease
Creatinine
Disease
Female
Histology
Humans
Hypercalcemia
Hypercalcemia - diagnosis
Hypercalcemia - etiology
Lymphatic system
Mutation
Neuroendocrine tumors
Obstetrics
Parathyroid Glands
Parathyroid Hormone
Parathyroid Neoplasms - diagnosis
Parathyroid Neoplasms - diagnostic imaging
Pregnancy
Thyroid gland
Tumors
Ultrasonic imaging
Ventricular Premature Complexes
Vomiting
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Summary:Parathyroid carcinoma is very rare in pregnancy. Clinical features are similar to primary hyperparathyroidism. A 38-year-old pregnant woman had repeated hospital admissions for palpitations, headaches, dizziness and polydipsia. Blood investigations showed severe hypercalcaemia with raised parathyroid hormone and 24-hour ECG showed ventricular bigeminy and premature ventricular contractions. Neck ultrasound showed a lesion in the right thyroid lobe. Consequently, she underwent an en bloc resection of the right parathyroid and thyroid lobe at 23 weeks gestation. Histology results confirmed parathyroid cancer. This case highlights the complexities of identifying hypercalcaemia in pregnancy due to the overlapping features with common disorders of pregnancy. Early recognition and timely surgical management can prevent maternal and fetal complications. Also, the case demonstrates the value of interprofessional collaboration between different specialities in providing quality care and improving outcomes. An abridged version of this case was presented at European Congress of Endocrinology 2021.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2021-247069