Untimeliness of Diagnosis of Parathyroid Cancer on The Background of Long-Term Hypercalcemia

Hypercalcemia is a disorder of mineral metabolism that typically arises due to increased parathyroid gland function, leading to hyperparathyroidism. This condition can be triggered by various factors, such as the development of benign parathyroid hyperplasia, radiation exposure, the use of certain medications, decreased calcium levels in the body, renal pathology, impaired parathyroid gland function, and others. The complexity of diagnosing this condition is attributed to its rare occurrence and the absence of pathognomonic symptoms. The clinical manifestations of hypercalcemia are diverse and include gastrointestinal and nervous system disorders, as well as the development of urolithiasis and osteoporosis. The importance of timely diagnosis of hypercalcemia lies not only in the need to improve the patient’s quality of life and prevent complications but also in the early detection of the most severe cause of hyperparathyroidism—parathyroid cancer. This article discusses the case history of a 46-year-old patient, illustrating the delayed diagnosis of hypercalcemia and the development of parathyroid cancer despite long-standing clinical manifestations of hypercalcemia and persistent laboratory abnormalities, including elevated levels of alkaline phosphatase, free and ionized calcium. The clinical case analysis emphasizes the manifestations of hypercalcemia that should have alerted clinicians and guided the diagnostic process in the right direction. The importance of thorough history-taking and the interpretation of each clinical manifestation is underscored.

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