Control of Refractory Hypercalcemia with Denosumab in a Case of Metastatic Parathyroid Carcinoma. 2020

Murat Çalapkulu, and Ozen Oz Gul, and Soner Cander, and Canan Ersoy, and Erdinc Erturk, and Muhammed Fatih Sagiroglu, and Ozlem Saraydaroglu
Department of Endocrinology and Metabolism, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.

Parathyroid carcinoma is a rare cause of hyperparathyroidism and leads to severe hypercalcemia. The etiology is not fully known. Parathyroid cancer should be considered in the differential diagnosis, if serum calcium and parathyroid hormone levels increase, and parathyroid gland is palpable. Severe hypercalcemia is the most common cause of death in patients diagnosed with parathyroid carcinoma. Fluid replacement, diuretic therapy, bisphosphonates, and calcimimetic agents are the main treatment steps in the control of life-threatening hypercalcemia. Surgery is the primary treatment option, while denosumab is a treatment option for refractory hypercalcemia caused by parathyroid carcinoma, or for patients who are not eligible for surgery. There are few case reports in literature about denosumab treatment for parathyroid carcinoma. Herein, we report a case of a patient who presented with the complaint of leg pain and was diagnosed with parathyroid carcinoma. The elevated calcium level of the patient was controlled with denosumab. Key Words: Parathyroid carcinoma, Denosumab, Hypercalcemia, Hyperparathyroidism.

UI MeSH Term Description Entries
D010281 Parathyroid Hormone A polypeptide hormone (84 amino acid residues) secreted by the PARATHYROID GLANDS which performs the essential role of maintaining intracellular CALCIUM levels in the body. Parathyroid hormone increases intracellular calcium by promoting the release of CALCIUM from BONE, increases the intestinal absorption of calcium, increases the renal tubular reabsorption of calcium, and increases the renal excretion of phosphates. Natpara,PTH (1-84),PTH(1-34),Parathormone,Parathyrin,Parathyroid Hormone (1-34),Parathyroid Hormone (1-84),Parathyroid Hormone Peptide (1-34),Hormone, Parathyroid
D010282 Parathyroid Neoplasms Tumors or cancer of the PARATHYROID GLANDS. Cancer of Parathyroid,Parathyroid Cancer,Cancer of the Parathyroid,Neoplasms, Parathyroid,Parathyroid Adenoma,Parathyroid Carcinoma,Adenoma, Parathyroid,Adenomas, Parathyroid,Cancer, Parathyroid,Cancers, Parathyroid,Carcinoma, Parathyroid,Carcinomas, Parathyroid,Neoplasm, Parathyroid,Parathyroid Adenomas,Parathyroid Cancers,Parathyroid Carcinomas,Parathyroid Neoplasm
D004164 Diphosphonates Organic compounds which contain P-C-P bonds, where P stands for phosphonates or phosphonic acids. These compounds affect calcium metabolism. They inhibit ectopic calcification and slow down bone resorption and bone turnover. Technetium complexes of diphosphonates have been used successfully as bone scanning agents. Bisphosphonate,Bisphosphonates
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006934 Hypercalcemia Abnormally high level of calcium in the blood. Milk-Alkali Syndrome,Hypercalcemias,Milk Alkali Syndrome,Syndrome, Milk-Alkali
D000069448 Denosumab A humanized monoclonal antibody and an inhibitor of the RANK LIGAND, which regulates OSTEOCLAST differentiation and bone remodeling. It is used as a BONE DENSITY CONSERVATION AGENT in the treatment of OSTEOPOROSIS. AMG 162,Prolia,Xgeva
D050071 Bone Density Conservation Agents Agents that inhibit BONE RESORPTION and/or favor BONE MINERALIZATION and BONE REGENERATION. They are used to heal BONE FRACTURES and to treat METABOLIC BONE DISEASES such as OSTEOPOROSIS. Antiresorptive Agent,Antiresorptive Agents,Antiresorptive Drugs,Bone Resorption Inhibitors,Bone Resorption Inhibitory Agents,Agent, Antiresorptive,Inhibitors, Bone Resorption,Resorption Inhibitors, Bone

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