Coexistent Multiple Myeloma and Primary Hyperparathyroidism
- Marvin J. Stone, MD;
- Zelig H. Lieberman, MD;
- Zaven H. Chakmakjian, MD;
- J. Lester Matthews, PhD
- From the Charles A. Sammons Cancer Center (Drs Stone, Lieberman, Chakmakjian, and Matthews) and the Departments of Oncology (Drs Stone and Lieberman), Internal Medicine (Drs Stone and Chakmakjian), Surgery (Dr Lieberman), and Pathology (Drs Stone, Chakmakjian, and Matthews), Baylor University Medical Center, Dallas.
Abstract
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.
(JAMA 1982;247:823-824)
Footnotes
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Reprint requests to Charles A. Sammons Cancer Center, Baylor University Medical Center, 3500 Gaston Ave, Dallas, TX 75246 (Dr Stone).
