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Bo Hyun Kim 2 Articles
Secondary hyperparathyroidism due to multiple parathyroid carcinomas in a patient with chronic hemodialysis: a case report
Soree Ryang, Wook Yi, Mijin Kim, Sang Heon Song, Byung Joo Lee, Bo Hyun Kim
Kosin Med J. 2022;37(3):255-259.   Published online July 27, 2022
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
Parathyroid carcinoma (PC) in cases of secondary or tertiary hyperparathyroidism is relatively uncommon, and only a few case reports have described this entity. Although some papers have reported patients with one or two parathyroid malignancies, multiple PC–especially three or more–have been even more rarely reported. Herein, we report a case of secondary hyperparathyroidism due to multiple PCs in a chronic hemodialysis patient. A 54-year-old man with end-stage kidney disease was referred for hyperparathyroidism. He had been diagnosed with chronic kidney disease in 2001 and had begun hemodialysis in 2009. In laboratory tests, intact parathyroid hormone (iPTH) was markedly elevated to 1,144.1 pg/mL (normal range: 15.0–68.3 pg/mL) and serum calcium was mildly elevated to 10.56 mg/dL (normal range: 8.5–10.3 mg/dL). Ultrasonography showed hypoechoic nodules in the posterior part of both thyroid glands. All three nodules showed increased uptake on a 99mTc sestamibi scan. The patient underwent total parathyroidectomy with autotransplantation to the right forearm. Histopathology findings showed three PCs with capsular invasion and one parathyroid hyperplasia. In the immediate postoperative period, the iPTH level dropped from 1,446.8 to 82.4 pg/dL and, after 1 month, to 4.0 pg/dL. This patient needed oral calcium carbonate and active vitamin D to maintain appropriate serum calcium levels. Although multiple PCs are rare, they can cause secondary hyperparathyroidism. Therefore, clinicians should suspect multiple PCs when patients’ serum iPTH levels are exceptionally high. Additionally, since PCs could occur in multiple glands, autotransplantation of the parathyroid gland after parathyroidectomy should be done carefully.
A Case of F-18 FDG PET-CT Detection of Sporadic Medullary Thyroid Carcinoma and Cervical Lymph Node Metastasis of Ovarican Cancer
Joo Wan Seo, Chang Jun Park, Yun Kyung Jeon, Sang Soo Kim, Bo Hyun Kim, In Ju Kim
Kosin Med J. 2012;27(1):51-56.   Published online June 11, 2012
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM

Medullary thyroid carcinoma (MTC) is derived from the parafollicular or C-cells. As surgical resection is the only curative therapy for MTC, the early diagnosis is important for the patient's survival. F18-Fluorodeoxyglucose positron emission tomography-computed tomography (F-18 FDG PET CT) is a noninvasive imaging method which can be used to diagnose malignant thyroid tumors including recurrent or residual MTC. However, due to the limitations of this technique, it is difficult to differentiate benign from malignant thyroid tumors. We herein present a 47-year-old woman with ovarian cancer history who was found to have thyroid incidentaloma with metastatic cervical lymph node through F-18 FDG PET CT. Thyroid incidentaloma of the patient was examined by fine needle aspiration and the result of this diagnostic procedure showed suspicious MTC. The patient was subsequently diagnosed as having sporadic medullary thyroid carcinoma and metastatic cervical lymph node due to ovarian cancer.

KMJ : Kosin Medical Journal