Hypercalcaemia and bony lesions in association with parathyroid and prostatic carcinoma
Parathyroid carcinoma is a rare disease accounting for 0.1 - 5% of cases of primary hyperparathyroidismY The pre-operative differentiation between parathyroid carcinoma and benign forms of primary hyPerparathyroidism is difficult, as the presenting symptoms and signs are similar.' Postoperatively the diagnosis may remain unclear as pathological differentiation can be equally difficult.4 The distinction is, however, important as primary hyperparathyroidism due to a benign adenoma has an excellent prognosis, while the average survival in a series of patients with parathyroid carcinoma was reported to be 40 months.; Surgical removal of the tumour is at present the only effective therapy for parathyroid carcinoma.s Primary hyperparathyroidism coexisting with prostatic carcinoma has rarely been described: although it is known that there is an increased incidence of gynaecolOgical, thyroid and other malignancies in association with primary hyperparathyroidism.- As prostatic carcinoma is an unlikely cause of hypercalcaemia,' the presence of hypercalcaemia in a patient with prostatic carcinoma requires a search for an alternative underlying cause. We present the first described case of hypercalcaemia secondary to parathyroid carcinoma in a patient with prostatic carcinoma, and highlight the use of nuclear imaging in diagnosis and management.