{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:17:55Z","timestamp":1784557075076,"version":"3.55.0"},"reference-count":10,"publisher":"Bioscientifica","issue":"1","license":[{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["edm.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,1,1]]},"abstract":"\n Summary<\/jats:title>\n Emergencies due to malignancies usually have a severe clinical course and require urgent treatment. These scenarios are dubbed \u2018oncologic emergencies\u2019. Parathyroid tumours often cause hypercalcaemia but not oncologic emergencies. We present a case of parathyroid carcinoma with severe hypercalcaemia and pancreatitis, resolved by surgical resection of the tumour assisted by extracorporeal membrane oxygenation (ECMO). A 66-year-old woman presented to our hospital because of haematuria. Laboratory findings were as follows: white blood cell count: 30 000, C-reactive protein: 17.7, calcium: 21.9, creatine kinase: 316, creatine kinase-myoglobin binding: 20, troponin I: 1415.8, amylase: 1046, lipase: 499, blood urea nitrogen: 57, and creatinine: 2.42. ECG was unremarkable. CT revealed a 4-cm low-density irregular tumour in the left lobe of the thyroid gland and severe pancreatitis. We diagnosed hypercalcaemia and pancreatitis due to parathyroid carcinoma. Volume expansion with isotonic saline was started immediately. Calcitonin, followed by denosumab, calcimimetic agents, and continuous hemodiafiltration were administered. The patient\u2019s general condition worsened due to uncontrolled hypercalcaemia. Urgent tumour resection was planned, assisted with ECMO for cardiopulmonary support and surgical field venous pressure reduction. Tumour histology was suggestive of parathyroid carcinoma. Hypercalcaemia and the patient\u2019s general condition improved gradually postoperatively. Hypercalcaemia is one of the oncologic emergency symptoms, commonly occurring because of lytic bone metastasis. However, reports about parathyroid carcinoma-causing life-threatening hypercalcaemia and pancreatitis are scarce; the fatality of this condition is estimated to be 30\u201370%. We report a case of survival of hypercalcaemia of malignancy.<\/jats:p>\n <\/jats:sec>\n \n Learning points<\/jats:title>\n \n \n Parathyroid carcinoma is relatively rare and sometimes causes emergent conditions such as hypercalcaemia and severe pancreatitis.<\/jats:p>\n <\/jats:list-item>\n \n General therapy for hypercalcaemia including aggressive saline dehydration, administration of furosemide, calcitonin, zoledronic acid, and evocalcet, and dialysis is sometimes ineffective for parathyroid carcinoma. Therefore, careful planning of therapy in case of exacerbation is important.<\/jats:p>\n <\/jats:list-item>\n \n During an emergency, rapid surgical treatment despite high calcium level is the best potential therapeutic strategy.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:sec>","DOI":"10.1530\/edm-22-0323","type":"journal-article","created":{"date-parts":[[2023,1,6]],"date-time":"2023-01-06T06:03:35Z","timestamp":1672985015000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":1,"title":["Parathyroid carcinoma with pancreatitis causing hypercalcaemic emergency treated with extracorporeal membrane oxygenation-assisted parathyroid resection"],"prefix":"10.1530","volume":"2023","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1868-3914","authenticated-orcid":true,"given":"Madoka","family":"Toyoda","sequence":"first","affiliation":[{"name":"Department of Surgery, Yokohama City University, Yokohama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1139-6656","authenticated-orcid":true,"given":"Nobuyasu","family":"Suganuma","sequence":"additional","affiliation":[{"name":"Department of Surgery, Yokohama City University, Yokohama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akari","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Yokohama City University, Yokohama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5954-7823","authenticated-orcid":true,"given":"Taku","family":"Masuda","sequence":"additional","affiliation":[{"name":"Department of Surgery, Yokohama City University, Yokohama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masami","family":"Goda","sequence":"additional","affiliation":[{"name":"Department of Surgery, Yokohama City University, Yokohama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6963-5827","authenticated-orcid":true,"given":"Tatsuya","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Surgery, Yokohama City University, Yokohama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0411-6353","authenticated-orcid":true,"given":"Norio","family":"Yukawa","sequence":"additional","affiliation":[{"name":"Department of Surgery, Yokohama City University, Yokohama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoji","family":"Yamanaka","sequence":"additional","affiliation":[{"name":"Department of Surgical Pathology, Yokohama City University, Yokohama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6858-3420","authenticated-orcid":true,"given":"Yasushi","family":"Rino","sequence":"additional","affiliation":[{"name":"Department of Surgery, Yokohama City University, Yokohama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4844-7592","authenticated-orcid":true,"given":"Munetaka","family":"Masuda","sequence":"additional","affiliation":[{"name":"Department of Surgery, Yokohama City University, Yokohama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"Journal of Clinical Endocrinology and Metabolism","first-page":"485","article-title":"Clinical review 122: Parathyroid carcinoma","volume":"86","author":"Shane","year":"2001","unstructured":"Shane EClinical review 122: Parathyroid carcinoma. 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(https:\/\/doi.org\/10.1136\/bmj.h2723)"},{"key":"bib4","series-title":"Williams Textbook of Endocrinology","first-page":"1397","article-title":"Parathyroid hormone, calcitonin, and the calciferols","author":"Aurbach","year":"1992","unstructured":"Aurbach GDMarx SJSpeegl AM. Parathyroid hormone, calcitonin, and the calciferols. In Williams Textbook of Endocrinology, 8th ed., pp. 1397\u20131476. Eds., Wilson JDFoster DW: Philadelphia: W.B. Saunders Company1992."},{"key":"bib5","series-title":"Annals of Surgery","first-page":"782","article-title":"Hyperparathyroid crisis: Clinical and pathologic studies of 14 patients","volume":"190","author":"Wang","year":"1979","unstructured":"Wang CAGuyton SW. Hyperparathyroid crisis: Clinical and pathologic studies of 14 patients. Annals of Surgery1979190782\u2013790. (https:\/\/doi.org\/10.1097\/00000658-197912000-00019)"},{"key":"bib6","series-title":"Surgery","first-page":"741","article-title":"Hyperparathyroid crisis. 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(https:\/\/doi.org\/10.1507\/endocrine1927.69.10_1051)"},{"key":"bib8","series-title":"British Journal of Surgery","first-page":"979","article-title":"Acute primary hyperparathyroidism: experience of 59 cases","volume":"76","author":"Sarfati","year":"1989","unstructured":"Sarfati EDesportes LGossot DDubost C. Acute primary hyperparathyroidism: experience of 59 cases. British Journal of Surgery198976979\u2013981. (https:\/\/doi.org\/10.1002\/bjs.1800760937)"},{"key":"bib9","series-title":"Journal of Clinical Endocrinology and Metabolism","first-page":"2115","article-title":"Acute pancreatitis in primary hyperparathyroidism: a population-based study","volume":"94","author":"Khoo","year":"2009","unstructured":"Khoo TKVege SSAbu-Lebdeh HSRyu ENadeem SWermers RA. Acute pancreatitis in primary hyperparathyroidism: a population-based study. Journal of Clinical Endocrinology and Metabolism2009942115\u20132118. (https:\/\/doi.org\/10.1210\/jc.2008-1965)"},{"key":"bib10","series-title":"Indian Journal of Endocrinology and Metabolism","first-page":"100","article-title":"Primary hyperparathyroidism presenting as hypercalcemic crisis: twenty-year experience","volume":"19","author":"Singh","year":"2015","unstructured":"Singh DNGupta SKKumari NKrishnani NChand GMishra AAgarwal GVerma AKMishra SKAgarwal A. Primary hyperparathyroidism presenting as hypercalcemic crisis: twenty-year experience. Indian Journal of Endocrinology and Metabolism201519100\u2013105. (https:\/\/doi.org\/10.4103\/2230-8210.131763)"}],"container-title":["Endocrinology, Diabetes & Metabolism Case Reports"],"original-title":[],"link":[{"URL":"https:\/\/edm.bioscientifica.com\/view\/journals\/edm\/2023\/1\/EDM22-0323.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/edm.bioscientifica.com\/view\/journals\/edm\/2023\/1\/EDM22-0323.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/edm.bioscientifica.com\/view\/journals\/edm\/2023\/1\/EDM22-0323.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:48:01Z","timestamp":1784555281000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.bioscientifica.com\/edm\/article\/3157"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,1]]},"references-count":10,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.1530\/edm-22-0323","relation":{},"ISSN":["2052-0573"],"issn-type":[{"value":"2052-0573","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,1]]}}}