1987 年 5 巻 1 号 p. 1-7
Primary hyperparathyroidism was found in the father and daughter in a family, parathyroid carcinoma and adenoma being responsible, respectively.
A 57 year old man was admitted for the evaluation of recurrent gastric ulcers. Laboratory tests revealed hypercalcemia of 6.1mEq/l, hypophosphatemia of 1.8mg/dl and elevated plasma alkaline phosphatase of 40.5K. A. U., C-PTH of 13mIU/l (normal range, 1.0-4.2) and 1.25(OH)2 Vit D3 of 94.2pg/ml, and urinary cyclic AMP of 22700ng/day (normal 3100-7100). A firm mass (2×3cm) palpable on the right lower part of the anterior neck was proved to be parathyroid cancer on surgical removal with part of the right thyroid lobe.
The 24 year old daughter of this patient also showed hypercalcemia of 5.4mEq/l, hypophosphatemia of 2.3mg/dl, and elevated alkaline phosphatase of 14.9K. A. U., on consulting us with complaints of nausea, epigastralgia, thirst, polyuria and constipation. Serum C-PTH of 0.7ng/ml (normal<1.4) and N-PTH of 130pg/ml (normal 1-96) were thought to be high despite the hypercalcemia. A parathyroid tumor (6×12mm) removed from behind the upper part of the left thyroid lobe was found to be chief cell adenoma.
Familial hyperparathyroidism with parathyroid carcinoma have not been reported in Japan. We report the first case.
