Published Paper Details:

Introduction: Hypercalcaemia Crisis is a rare and serious complication of primary hyperparathyroidism. Parathyroid carcinoma is one of the causes of primary hyperparathyroidism that is very rare with an incidence of 0,005% of all malignancy cases. Case Presentation: We report the case of 46-year-old Man with hypercalcaemia crisis due to parathyroid carcinoma. He presented with right upper arm and left thigh fractures after falling while riding a motorcycle. Because a pathological fracture is suspected, further diagnostic examination is carried out. His serum calcium and parathyroid hormone levels were at 15,3 mg/dL and 4.063 pg/mL, respectively. An ultrasonography of his neck showed a nodul in the left lobe of thyroid gland (TIRADS 4) while the parathyroid gland was not visualized and abdominal ultrasonography showed bilateral nephrolithiasis. A total Thyroidectomy and total parathyroidectomy were performed. Histology revealed a parathyroid carcinoma with an intranodular parathyroid in the left lobe thyroid. Postoperatively, the patient has a significant decrease in serum calcium and PTH levels. Conclusion: In patient with parathyroid carcinoma, the best treatment modality is surgery. In our patient, surgical intervention in the form of total parathyroidectomy proved successfully reduce serum calcium and PTH levels. Early diagnosis and surgery before arising the complications of the hypercalcaemia crisis, nephrolithiasis, or pathological fractures could reduce morbidity and mortality in patient with parathyroid carcinoma.