Coexistent multiple myeloma and primary hyperparathyroidism
M. J. Stone, Z. H. Lieberman, Z. H. Chakmakjian and J. L. Matthews
A patient with multiple myeloma and hypercalcemia responded to cytotoxic
chemotherapy. However, hypercalcemia persisted. Because of the absence of
lytic bone lesions, the presence of a low serum phosphate level, and a
family history of possible primary hyperparathyroidism, the patient was
evaluated for this disorder. Serum parathyroid hormone and urinary cyclic
adenosine monophosphate levels were elevated. Exploration of the neck
disclosed two enlarged parathyroid glands (1,850 mg and 210 mg), which were
excised. After surgery, the patient's serum calcium levels remained normal
for one year. Progressive myeloma bone disease developed that eventually
resulted in recurrent hypercalcemia and death. Autopsy revealed only
evidence of myeloma.
