Tertiary Renal Hyperparathyroidism : The Case of Irradiation-Induced Hyperparathyroidism With Differential Diagnosis of Parathyroid Carcinoma in the Patient Occupationally Over Exposed to Ionizing Radiation

Radiation-induced hyperparathyroidism in tertiary renal hyperparathyroidism was diagnosed in a patient that was exposed to ionizing radiation for 25 years. After preoperative localization, surgical excision showed an enlarged right lower parathyroid gland with invasion into the surrounding structures. Pathohistological examination established the diagnosis of parathyroid hyperplasia, but the main differential diagnosis of parathyroid carcinoma was due to the type of growth seen in patients who were over exposed to x-irradiation. During the next 5 years, regularly checking biochemical markers and imaging studies every 6 months, no further local growth or metastases of parathyroid carcinoma were found. This report demonstrates, for the first time, the effect of low dose ionizing radiation on parathyroid health.