Ethanol injection under ultrasound guidance to palliate unresectable parathyroid carcinoma
BACKGROUND: Severe hypercalcemia is the leading cause of death in patients with parathyroid carcinoma. Non-curative resection and pharmacological measures may be useful for palliation in cases with recurrent and metastatic disease. Palliative treatment with intra-neoplastic ethanol injection has not been reported yet. METHODS: Ultrasound-guided percutaneous alcohol injection in one patient with unresectable parathyroid carcinoma is reported. RESULTS: One male patient with extensive recurrent parathyroid carcinoma suffering from severe hypercalcemia, refractory to all available medical measures has undergone two percutaneous ethanol injections. No major complications ensued and parathormone levels decreased from 2,990 pg/mL to 2,230pg/ml after the first injection, and to 1,104pg/mL after the second one. Calcium levels decreased from 19.8 mg/dL to 16.1 mg/dL and to 14.5 mg/dL, respectively. The patient died of metabolic hypercalcemia complications about two months later, probably due to mediastinal disease progression. CONCLUSION: Ultrasound-guided percutaneous ethanol injection may be employed to palliate parathyroid carcinoma in selected cases, with a transitory decrease in PTH and calcium levels.
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Sociedade Brasileira de Endocrinologia e Metabologia
2008
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oai:scielo:S0004-273020080004000192008-06-24Ethanol injection under ultrasound guidance to palliate unresectable parathyroid carcinomaMontenegro,Fábio Luiz de MenezesChammas,Maria CristinaJuliano,Adriana GonçalvesCernea,Claudio RobertoCordeiro,Anói Castro Hyperparathyroidism, primary Parathyroid neoplasms Parathyroid hormone Parathyroid glands Hypercalcemia Ultrasonography, Interventional BACKGROUND: Severe hypercalcemia is the leading cause of death in patients with parathyroid carcinoma. Non-curative resection and pharmacological measures may be useful for palliation in cases with recurrent and metastatic disease. Palliative treatment with intra-neoplastic ethanol injection has not been reported yet. METHODS: Ultrasound-guided percutaneous alcohol injection in one patient with unresectable parathyroid carcinoma is reported. RESULTS: One male patient with extensive recurrent parathyroid carcinoma suffering from severe hypercalcemia, refractory to all available medical measures has undergone two percutaneous ethanol injections. No major complications ensued and parathormone levels decreased from 2,990 pg/mL to 2,230pg/ml after the first injection, and to 1,104pg/mL after the second one. Calcium levels decreased from 19.8 mg/dL to 16.1 mg/dL and to 14.5 mg/dL, respectively. The patient died of metabolic hypercalcemia complications about two months later, probably due to mediastinal disease progression. CONCLUSION: Ultrasound-guided percutaneous ethanol injection may be employed to palliate parathyroid carcinoma in selected cases, with a transitory decrease in PTH and calcium levels.info:eu-repo/semantics/openAccessSociedade Brasileira de Endocrinologia e MetabologiaArquivos Brasileiros de Endocrinologia & Metabologia v.52 n.4 20082008-06-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27302008000400019en10.1590/S0004-27302008000400019 |
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Montenegro,Fábio Luiz de Menezes Chammas,Maria Cristina Juliano,Adriana Gonçalves Cernea,Claudio Roberto Cordeiro,Anói Castro |
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Montenegro,Fábio Luiz de Menezes Chammas,Maria Cristina Juliano,Adriana Gonçalves Cernea,Claudio Roberto Cordeiro,Anói Castro Ethanol injection under ultrasound guidance to palliate unresectable parathyroid carcinoma |
author_facet |
Montenegro,Fábio Luiz de Menezes Chammas,Maria Cristina Juliano,Adriana Gonçalves Cernea,Claudio Roberto Cordeiro,Anói Castro |
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Montenegro,Fábio Luiz de Menezes |
title |
Ethanol injection under ultrasound guidance to palliate unresectable parathyroid carcinoma |
title_short |
Ethanol injection under ultrasound guidance to palliate unresectable parathyroid carcinoma |
title_full |
Ethanol injection under ultrasound guidance to palliate unresectable parathyroid carcinoma |
title_fullStr |
Ethanol injection under ultrasound guidance to palliate unresectable parathyroid carcinoma |
title_full_unstemmed |
Ethanol injection under ultrasound guidance to palliate unresectable parathyroid carcinoma |
title_sort |
ethanol injection under ultrasound guidance to palliate unresectable parathyroid carcinoma |
description |
BACKGROUND: Severe hypercalcemia is the leading cause of death in patients with parathyroid carcinoma. Non-curative resection and pharmacological measures may be useful for palliation in cases with recurrent and metastatic disease. Palliative treatment with intra-neoplastic ethanol injection has not been reported yet. METHODS: Ultrasound-guided percutaneous alcohol injection in one patient with unresectable parathyroid carcinoma is reported. RESULTS: One male patient with extensive recurrent parathyroid carcinoma suffering from severe hypercalcemia, refractory to all available medical measures has undergone two percutaneous ethanol injections. No major complications ensued and parathormone levels decreased from 2,990 pg/mL to 2,230pg/ml after the first injection, and to 1,104pg/mL after the second one. Calcium levels decreased from 19.8 mg/dL to 16.1 mg/dL and to 14.5 mg/dL, respectively. The patient died of metabolic hypercalcemia complications about two months later, probably due to mediastinal disease progression. CONCLUSION: Ultrasound-guided percutaneous ethanol injection may be employed to palliate parathyroid carcinoma in selected cases, with a transitory decrease in PTH and calcium levels. |
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Sociedade Brasileira de Endocrinologia e Metabologia |
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2008 |
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http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27302008000400019 |
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