초록 close

저자들은 특별한 외상없이 중수골의 골절이 생겼고 피로감과 다발성 관절통 및 요통 등의 증상을 보인 여자 환자에서 심한 골감소 및 다발성 골용해 병변과 부갑상선 종괴를 발견하고, 부갑상선 종괴를 동측의 갑상선과 함께 절제하여 부갑상선암을 진단하였으며, 수술 후 혈중 칼슘과 부갑상선 호르몬의 정상화까지 보였으나, 수술 6주 경과 후 혈중 칼슘과 부갑상선 호르몬이 증가하여 다발성 골용해 병변을 부갑상선암의 전이병소로 임상적 진단을 하고 골 병변에 대한 방사선 요법을 시행하여 부갑상선 호르몬이 감소한 환자의 1예를 경험하였기에 보고한다.


Parathyroid carcinoma is a rare malignancy that is responsible for only 0.5 to 4% of all cases of primary hyperparathyroidism. Surgery is the only curative treatment. We report a case of a 46-year-old woman referred for a severe osteoporosis with frequent bone fracture associated with hypercalcemia. Initially, though she had multiple osteolytic lesions, we thought that the lesions were brown tumors resulting from hyperparathyroidism. The patient underwent surgery and was diagnosed with parathyroid carcinoma. After surgery, her intact PTH level normalized for brief period of time, but it was again elevated at 6 weeks after surgery. We suggest that the multiple osteolytic lesions were metastases because there was no evidence of local recurrence of parathyroid carcinoma, and the lesions looked like metastases on CT and PET-CT. The patient was treated with radiation therapy on the lumbar vertebra, one a site of the metastatic lesions. After radiotherapy, her serum intact PTH was decreased. (J Kor Endocrine Soc 22:344~352, 2007)