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World J Clin Cases. May 16, 2014; 2(5): 151-156
Published online May 16, 2014. doi: 10.12998/wjcc.v2.i5.151
Published online May 16, 2014. doi: 10.12998/wjcc.v2.i5.151
Parathyroid carcinoma in pregnancy
Maja Baretić, Division of Endocrinology, Department of Internal Medicine, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
Hrvojka Tomić Brzac, Margareta Dobrenić, Clinical Department of Nuclear Medicine and Radiation Protection, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
Antonia Jakovčević, Department of Pathology and Cytology, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
Author contributions: Baretić M wrote and designed the report, was responsible for the patient treatment and follow up, analyzed the data and wrote the paper; Tomić Brzac H performed and commented on the ultrasound exam; Dobrenić M performed and commented on the nuclear medicine exam; and Jakovčević A performed the pathology report analysis and made comments.
Correspondence to: Maja Baretić, MD, PhD, Division of Endocrinology, Department of Internal Medicine, University Hospital Centre Zagreb, Zavod za endokrinologiju Kišpatićeva 12, 10000 Zagreb, Croatia. maja.simek@zg.t-com.hr
Telephone: +385-98-412284 Fax: +385-1-2376036
Received: December 24, 2013
Revised: March 20, 2014
Accepted: April 3, 2014
Published online: May 16, 2014
Revised: March 20, 2014
Accepted: April 3, 2014
Published online: May 16, 2014
Core Tip
Core tip: Parathyroid carcinoma is the rarest endocrine malignancy; it is extremely uncommon in pregnancy. Hyperemesis gravidarum can mask the symptoms of hypercalcemia. The calcium level can be lower during pregnancy due to its specific physiology. This is a case report of a 24-year-old female patient with parathyroid carcinoma and two consecutive pregnancies with good outcomes in the postnatal period despite poor prognosis due to malignant disease. In five years, four consecutive surgeries were performed to remove malignant parathyroid tissue, lymph nodes and local metastases. Hypercalcemia was difficult to control with a combination of pamidronate, cinacalcet and loop diuretic. There were no elements of multiple endocrine neoplasia.