Ohe Monique Nakayama, Santos Rodrigo Oliveira, Hojaij Flavio, Neves Murilo Catafesta, Kunii Ilda Sizue, Orlandi Denise, Valle Luisa, Martins Carla, Janovsky Carolina, Ferreira Rimarcs, Delcelo Roseane, Domingos Ana Maria, Abrahão Marcio, Cervantes Onivaldo, Lazaretti-Castro Marise, Vieira Jose Gilberto Henriques
Division of Endocrinology and Metabolism, Escola Paulista de Medicina, Universidade Federal de São Paulo (Unifesp/ EPM), Sao Paulo, SP, Brazil.
Arq Bras Endocrinol Metabol. 2013 Feb;57(1):79-86. doi: 10.1590/s0004-27302013000100011.
We hereby report two patients with parathyroid carcinoma presenting extremely high calcium and PTH levels, severe bone disease, and palpable neck mass at diagnosis. They both underwent parathyroidectomy, and one of them evolved to lung metastasis. Important hypocalcemia was observed after surgery in both: after parathyroidectomy in one patient, and only after surgical removal of the metastasis in the other. Both required intravenous calcium replacement, thus revealing hungry bone syndrome (HBS). HBS usually reflects rapid mineralization after correction of hyperparathyroidism. The more severe the bone disease before surgery, the more prone the patient is to HBS after surgery. Despite being an unfavorable outcome, HBS state suggests that surgical removal of hypersecretory parathyroid tissue was accomplished. In this study, HBS was observed in both patients, who presented severe bone disease prior to surgery. HBS would be expected post-operatively in successful parathyroid carcinoma removal.
我们在此报告两例甲状旁腺癌患者，其在诊断时呈现出极高的血钙和甲状旁腺激素水平、严重的骨病以及可触及的颈部肿块。他们均接受了甲状旁腺切除术，其中一例发生了肺转移。术后两人均出现了严重的低钙血症：一例患者在甲状旁腺切除术后出现，另一例仅在手术切除转移灶后出现。两人均需要静脉补钙，从而揭示了饥饿骨综合征（HBS）。HBS通常反映甲状旁腺功能亢进纠正后的快速矿化。术前骨病越严重，患者术后发生HBS的可能性就越大。尽管HBS是一种不良结局，但它表明已成功手术切除了分泌过多甲状旁腺组织。在本研究中，两名术前存在严重骨病的患者均出现了HBS。成功切除甲状旁腺癌后，术后预计会出现HBS。
