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Malignancy and concomitant primary hyperparathyroidism.

W E Strodel1, N W Thompson, F E Eckhauser

  • 1Division of Endocrine Surgery, University of Michigan Medical School, Ann Arbor.

Journal of Surgical Oncology
|January 1, 1988
PubMed
Summary
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Malignant tumors can cause hypercalcemia due to primary hyperparathyroidism. Evaluating parathyroid hormone (PTH) levels is crucial for diagnosis and guiding treatment with parathyroidectomy.

Area of Science:

  • Endocrinology
  • Oncology
  • Surgical Oncology

Background:

  • Hypercalcemia is frequently linked to malignant neoplasms, both primary and metastatic.
  • Hyperparathyroidism is often overlooked as a cause of hypercalcemia in cancer patients.

Purpose of the Study:

  • To investigate the incidence and characteristics of hyperparathyroidism in patients with malignant tumors presenting with hypercalcemia.
  • To assess the diagnostic utility of parathyroid hormone (PTH) levels and the efficacy of surgical intervention.

Main Methods:

  • Retrospective analysis of 18 patients with malignant tumors and hypercalcemia over a 6-year period.
  • Evaluation of serum calcium, phosphate, chloride, and C-terminal PTH levels.
  • Surgical exploration and parathyroidectomy for confirmed hyperparathyroidism.

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Main Results:

  • 18 patients (5 male, 13 female, mean age 48) with various malignancies (colon, breast, lymphoma, thyroid, Paget's, lung) presented with hypercalcemia.
  • Elevated C-terminal PTH levels (average 1,150 pg/ml) were observed.
  • Parathyroid adenoma (15 patients) or hyperplasia (3 patients) was identified, with normalization of calcium levels post-surgery.

Conclusions:

  • Hyperparathyroidism should be considered in cancer patients with hypercalcemia.
  • Elevated PTH levels are diagnostic for primary hyperparathyroidism in this context.
  • Surgical management (parathyroidectomy) is effective in resolving hypercalcemia caused by hyperparathyroidism in patients with malignancies.