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증례 : 신부전과 빈혈로 발현된 이소성 부갑상선암 1예
강명수 ( Myong Su Kang ),이호연 ( Ho Yun Lee ),서평주 ( Pyong Ju Seo ),김희진 ( Hee Jin Kim ),윤성철 ( Sung Chul Yun ),서필원 ( Phil Won Seo ),권미선 ( Mi Seon Kwon ) 대한내과학회 2006 대한내과학회지 Vol.71 No.4
저자들은 일차성 부갑상선기능항진증으로 인한 고칼슘혈증, 급성신부전, 대사성 골질환 및 심한 빈혈을 보인 환자에서 이소성 종격동 부갑상선암을 절제한 후 고칼슘혈증 뿐 아니라 골수섬유증에 의한 빈혈과 급성신부전도 호전된 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Parathyroid carcinoma is an uncommon cause of PTH-related hypercalcemia with a reported incidence of 0.4% to 5% of all cases of primary hyperparathyroidism. Even though the clinical manifestations of hyperparathyroidism are more severe in patients with parathyroid carcinoma than in those with parathyroid adenoma, it is difficult to differentiate carcinoma from adenoma preoperatively. Parathyroid carcinomas are usually larger and firmer than parathyroid adenomas and patients with parathyroid carcinoma have a higher incidence of renal dysfunction, bone disease and gastrointestinal symptoms. Anemia is an uncommon clinical feature of parathyroid carcinoma. There have been no prior cases of ectopic parathyroid carcinomas reported to date. In this article, we report the case of a 26-year-old man who developed severe anemia and acute renal failure due to an ectopic parathyroid tumor and was diagnosed with parathyroid carcinoma postoperatively. His serum calcium levels returned to normal and the anemia resolved postoperatively.(Korean J Med 71:435-441, 2006)