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Int J Clin Exp Med 2010;4(3):234-240
Ectopic secretion of parathyroid hormone in a neuroendocrine tumor: A case report
and review of the literature
Emad Kandil, Salem Noureldine, Mohamed Abdel Khalek, Philip Daroca, Paul Friedlander
Division of Endocrine and Oncologic Surgery, Department of Surgery; Department of Pathology, Tulane University School of Medicine,
New Orleans, LA; Department of Otolaryngology; Tulane University School of Medicine, New Orleans, LA, USA.
Received March 30, 2011; accepted August 19, 2011; Epub September 15, 2011; published September 30, 2011
Abstract: Very few cases have been reported in which the production and secretion of intact PTH by a non-parathyroid tumor has been
authenticated. This paper describes the case of a 73 year old white female with a clinical and biochemical profile characteristic of
primary hyperparathyroidism. Sestamibi scan and comprehensive neck ultrasonography failed to localize a cervical lesion. Because
the clinical manifestations were striking, neck exploration was performed. Dissection of the central compartment identified a lesion.
PTH levels dropped to normal within ten minutes after its removal. Intraoperative parathyroid hormone assays facilitated the successful
surgical removal of the lesion. Pathological examination yielded a diagnosis of a neuroendocrine tumor. These results document the
ectopic production of intact PTH by a neuroendocrine tumor and present a novel neoplastic cause of primary hyperparathyroidism. This
is the second report of an ectopic neuroendocrine tumor in the head and neck which secreted intact PTH. (IJCEM1103003).
Key words: Ectopic Neuroendocrine tumor, Ectopic PTH, Primary Hyperparathyroidism, Intraoperative PTH assays
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Address all correspondence to:
Emad Kandil, MD
Section Chief, Endocrine Surgery
Tulane University School of Medicine