UROLITHIASIS AND UROSEPSIS IN CONCURRENT HYPERPARATHYROIDISM AND PARATHYROID CARCINOMA

A 76-year-old female patient was admitted with a two week-history of c hills due to pelvic uretral calculi and hydronephrosis. Sonogram and i ntravenous pyelogram revealed a third degree hydronephrosis and pyonep hrosis. A percutaneous nephrostoma was applied, but the patient develo ped septic shock with coagulopathy and respiratory insufficiency the n ext day, making emergency nephrectomy necessary. Further follow-up sho wed additional hypercalcemia and hypophosphatemia with a rise in parat hormone level and a suspicious sonogram of the parathyreoidal glands. Parathyreoidectomy was performed leading to normalization of the calci um and phosphate serum levels. Histologic findings displayed a solid, growing G1 carcinoma and nodular hyperplasia of the parathyreoidal gla nd.