LUNG METASTASIS FROM PARATHYROID CARCINOMA CAUSING RECURRENT RENAL HYPERPARATHYROIDISM IN A HEMODIALYSIS PATIENT - REPORT OF A CASE

We report herein the case of a 46-year-old woman on hemodialysis (HD) who developed recurrent renal hyperparathyroidism induced by lung meta stasis from parathyroid carcinoma, The patient had been commenced on H D for chronic renal failure about 20 years earlier and had undergone a parathyroidectomy for advanced renal hyperparathyroidism 8 years late r. After the initial operation, further explorations of the neck were performed due to recurrence, despite which the hyperparathyroidism per sisted and she was finally referred to our department, The appearance of multiple coinlike lesions on a chest X-ray and computed tomography led to the diagnosis of recurrent hyperparathyroidism induced by lung metastasis from parathyroid carcinoma. A pulmonary wedge resection was performed and the metastatic parathyroid nodules were removed. Of the several hypotheses about the etiology of parathyroid carcinoma in HD patients, it is most likely that the parathyroid hyperplasia induced b y chronic renal failure develops into carcinoma. Even in renal hyperpa rathyroidism, we should bear in mind the possibility that metastatic p arathyroid carcinoma is a possible source of excess parathyroid hormon e secretion at recurrence.