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Case Presentation Parathyroid adenoma vs carcinoma 03.02.2020

Endocrine Grand Rounds
Case 14-11-98: A 63-year-old Lady with “Hypercalcemia”

A 63-year-old lady with no known past medical history and a history of tibial fracture 8 months ago, after which she experienced constipation ,malaise, generalized bone pain and inability to walk properly due to extreme weakness and malaise . She also complains of polydipsia, polyuria and significant weight loss of about 20kg during past 8 months.

 She subsequently sought medical attention and the laboratory  work up of high serum calcium were detected.

  • Constitutional symptoms: Lack of energy, unexplained weight gain or weight loss, loss of appetite,

Negative :fever, night sweats, pain in jaws when eating, scalp tenderness, prior diagnosis of cancer).

  • Eyes, Ears, nose, mouth, throat: Negative (Difficulty with hearing, sinus problems, runny nose, post-nasal drip, ringing in ears, mouth sores, loose teeth, ear pain, nosebleeds, sore throat, facial pain or numbness).

Cardiovascular: chest pains

  • Negative (Irregular heartbeat, racing heart,, swelling of feet or legs, pain in legs with walking).
  • Respiratory: Negative (Shortness of breath, night sweats, prolonged cough, wheezing, sputum production, prior tuberculosis, pleurisy, oxygen at home, coughing up blood, abnormal chest x-ray).

Gastrointestinal:constipation

  •  Negative (Heartburn,, intolerance to certain foods, diarrhea, abdominal pain, difficulty swallowing, nausea, vomiting, blood in stools, unexplained change in bowel habits, incontinence).

Genitourinary: frequent urination

  • Negative (Painful urination,, urgency, prostate problems, bladder
  • problems, impotence).
  • Integumentary: Negative (Persistent rash, itching, new skin lesion, Acnea ,hirsutism,change in existing skin lesion, hair loss or increase, breast changes).
  • Neurological: Negative (Frequent headaches, double vision, weakness, change in sensation, problems with walking or balance, dizziness, tremor, loss of consciousness, uncontrolled
  • motions, episodes of visual loss).