ECE2024 Eposter Presentations Calcium and Bone (102 abstracts)
Hypercalcemia in locally advanced laryngeal cancer: an etiology to consider and a case report
Houas Jihene 1 , Heyfa Belhadj-Miled 1 , Monia Ghammam 1 , Ben Arfi Tayssir 1 , Malika El Omri 1 , Abir Meherzi 1 , Mouna Bellakhdhar 1 , El Ghali Wassim 2 , Yosra Hasni El Abed 3 , Wassim Kermani 1 & Mohamed Abdelkafi 1
1Farhat Hached Hospital, ENT department, Sousse, Tunisia; 2, Department of Anaesthesia, Sousse, Tunisia; 3, departement of endocrinology, Sousse, Tunisia
Introduction: Although Primary hyperparathyroidism is the most common cause of hypercalcemia in the general population, it is a less frequent cause of hypercalcemia among patients with cancer. It is estimated that approximately 80% of the hypercalcemia in cancer is mediated by humoral hypercalcemia of malignancy resulting from elevated parathyroid hormone-related peptide (PTHrp), while almost 20% is the result of local osteolytic hypercalcemia. The aim of this work is to present a clinical case of head and neck cancer associated with hypercalcemia and the etiological and therapeutic management.
Observation: This concerns a 75-year-old man, known to have diabetes and a history of alcohol and tobacco use, who was admitted to our ENT department for the management of laryngeal dyspnea overlaid on chronic hoarseness that the patient had neglected. Upon examination: A poorly defined, hard, midline cervical mass was observed, adjacent to the thyroid cartilage, with skin infiltration. Clinically suspicious cervical lymph nodes were present. CT scan revealed an extensive tumoral process of the larynx invading the three levels, classified as T4aN2. Direct laryngoscopy with biopsy confirmed the diagnosis of laryngeal squamous cell carcinoma. Additionally, asymptomatic hypercalcemia of 2.8 mmol/l was incidentally discovered during the pre-surgical biological assessment. Parathyroid hormone (PTH) was measured at 123 ng/l, and parathyroid scintigraphy returned negative. The patient underwent an extended total laryngectomy with total thyroidectomy and central and bilateral lateral neck dissection. Postoperatively, calcium and PTH levels normalized. The final histopathological examination confirmed the cancer diagnosis and identified a 2 cm parathyroid adenoma.
Conclusion: Although primary hyperparathyroidism is a less common cause of hypercalcemia in malignancy, it nonetheless should not be overlooked and an elevated calcium concentration cannot always be attributed to a known malignancy.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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