01972nas a2200217   4500008004100000024000700041245008900048210006900137260001800206300001200224490000700236520132000243653001601563653001801579653002101597653002201618653003201640100002301672700001901695856004001714       2022                        eng d  a2800aParathyroid Carcinoma Mimicking Multiple Myeloma: A Tale of Refractory Hypercalcemia0 aParathyroid Carcinoma Mimicking Multiple Myeloma A Tale of Refra  cDecember 2022  a863-8660 v143 a<p class="rtejustify">Primary hyperparathyroidism yields various symptoms, including hypercalcemia, pathological fracture, and renal impairment. Parathyroid carcinoma is the rarest cause of primary hyperparathyroidism, accounting for &lt;1% of the cases. We reported a case of a 46-year-old male with closed fractures at the humerus and femur. Further findings revealed severe refractory hypercalcemia, renal impairment, anemia, and bone lytic lesion (CRAB). No palpable cervical mass was identified. Surprisingly, the serum protein electrophoresis was normal, and urinary Bence-Jones protein was negative along with normal bone marrow aspiration. Hence, multiple myeloma was unlikely. The intact parathyroid hormone level was very high, along with a suspicious nodule on the left thyroid lobe (TIRADS 4). Total thyroidectomy and total parathyroidectomy were performed. The post-surgical pathological examination confirmed the diagnosis of parathyroid carcinoma. After the surgery, the patient was in stable condition with normal intact parathyroid hormone and serum calcium levels. In this case, primary hyperparathyroidism was caused by parathyroid carcinoma with “CRAB” symptoms, mimicking multiple myeloma. Primary hyperparathyroidism should be considered in the patient with refractory hypercalcemia.</p>
10aCase report10aHypercalcemia10aMultiple myeloma10aParathyroid tumor10aPrimary hyperparathyroidism1 aJonatan, Christian1 aWibisono, Sony  uhttps://www.phcogj.com/article/1892