Parathyroid Carcinoma with Hungry Bone Syndrome Complication After Parathyroidectomy: A Case Report
DOI:
https://doi.org/10.66266/inajemd.v1i2.17Keywords:
Riedel’s thyroiditis, tamoxifen, prednisoloneAbstract
Riedel's thyroiditis is a rare fibrotic condition involving damage to the thyroid gland and infiltration of surrounding structures. Synonyms of Riedel's thyroiditis include Riedel's goiter, fibrous goiter, ligneous goiter, or chronic invasive fibrous thyroiditis. The inflammatory thyroid condition of Riedel's thyroiditis is a local manifestation of a systemic fibrous or autoimmune process and chronic sclerosis or productive thyroiditis. A 59-year-old man came to the Endocrinology Clinic at Wahidin Sudirohusodo Hospital and was consulted by an oncology surgeon colleague with complaints of a lump in his neck for 2 years before coming to the hospital. Initially the lump was the size of a marble then it got bigger, felt hard, and not painful. The patient had a history of biopsies by surgical colleagues 2 times, the first in May 2022 Fine Needle Aspiration Biopsy with Malignancy (Papillary) results at Bhayangkara Hospital, then the patient was referred to a surgical oncology colleague at Wahidin Sudirohusodo Hospital and a 1-month incision biopsy was performed before going to the endocrine polyclinic with the results of Riedel's Thyroiditis. The patient was then given therapy with Tamoxifen 20 mg per 24 hours orally, and Methylprednisolone 16 mg per 8 hours orally with tapering doses every 7 days. In the treatment during control there were no complaints but complaints of a lump in the neck tended to shrink so the treatment was continued for 2 months then the patient returned to control with a clinical lump in the neck shrinking (Improvement). Riedel's thyroiditis is a disease characterized by an overgrowth of connective tissue that can invade surrounding structures. This connective tissue growth may extend into the recurrent laryngeal nerve. This thyroid inflammatory condition is suspected as a local manifestation of a systemic fibrotic process or an autoimmune process. Commonly used therapies such as glucocorticoids and immunosuppressant agents such as tamoxifen. Steroid treatment is usually given at a dose of 100 mg of prednisolone daily.
Downloads
References
1. Shoback DM, Schafer AL, Bikle DD. Metabolic Bone Disease. In: Gardner DG, Shoback D, editors. Greenspan’s Basic & Clinical Endocrinology. 10th ed. United States: McGraw-Hill Education; 2018. p. 258–66.
2. Bringhurst FR, Demay MB, Kronenberg HM. Hormones and Disorders of Mineral Metabolism. In: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, editors. Williams Textbook of Endocrinology. 14th ed. Philadelphia: Elsevier; 2020. p. 1220–38.
3. Schulte KM, Talat N, Galatá G. Margin Free Resection Achieves Excellent Long-Term Outcomes in Parathyroid Cancer. Cancers (Basel). 2022 Dec 29;15(1):199.
4. Kolsi N, Jellali S, Koubaa J. [Parathyroid carcinoma: about a case and review of the literature]. Pan Afr Med J. 2020;37:369.
5. Chandran M, Bilezikian JP, Salleh NM, Ying H, Lau J, Lee J, deJong MC, Chan Maung A, Parameswaran R. Hungry bone syndrome following parathyroidectomy for primary hyperparathyroidism in a developed country in the Asia Pacific. A cohort study. Osteoporos Sarcopenia. 2022;8(1):11-16.
6. Quaglino F, Manfrino L, Cestino L, Giusti M, Mazza E, Piovesan A, et al. Parathyroid Carcinoma: An Up-to-Date Retrospective Multicentric Analysis. Int J Endocrinol; 2020:7048185.
7. Kowalski GJ, Bednarczyk A, Buła G, Gawrychowska A, Gawrychowski J. Parathyroid carcinoma - a study of 29 cases. Endocrinol Pol. 2022; 73(1):56–63.
8. Do Cao C, Aubert S, Trinel C, Odou MF, Bayaram M, Patey M. Parathyroid carcinoma: Diagnostic criteria, classification, evaluation. Ann Endocrinol (Paris). 2015; 76(2):165–8.
9. Wilhelm SM, Wang TS, Ruan DT, Lee JA, Asa SL, Duh QY, et al. The American Association of Endocrine Surgeons Guidelines for Definitive Management of Primary Hyperparathyroidism. JAMA Surg. 2016; 151(10):959–68.
10. Pereira CA, Garrido S, Amaral C, Lima O, Cardoso H. Severe symptomatic hyperparathyroidism-Is it carcinoma? -Case report and literature review. Clin Case Rep. 2020; 8(8):1476–8.
11. Sali AP, Motghare P, Bal M, Mittal N, Rane S, Kane S, et al. Parathyroid Carcinoma: A Single-Institution Experience with an Emphasis on Histopathological Features. Head Neck Pathol. 2021;15(2):544–54.
12. Cartwright C, Anastasopoulou C. Hungry Bone Syndrome. StatPearls. 2023.
13. Jakubauskas M, Beiš a V, Strupas K. Risk factors of developing the hungry bone syndrome after parathyroidectomy for primary hyperparathyroidism. Acta Med Litu [Internet]. 2018; 25(1):45–51.
14. Witteveen JE, van Thiel S, Romijn JA, Hamdy NA. Hungry bone syndrome: still a challenge in the post-operative management of primary hyperparathyroidism: a systematic review of the literature. Eur J Endocrinol;168(3).
Downloads
Published
Issue
Section
License
Copyright (c) 2024 InaJEMD - Indonesian Journal of Endocrinology Metabolic and Diabetes

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors retain copyright and grant the Indonesian Journal of Endocrinology, Metabolism and Diabetes (InaJEMD) the right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
© Indonesian Journal of Endocrinology, Metabolism and Diabetes (InaJEMD). Published by the Indonesian Society of Endocrinology (PERKENI).


