Pseudohyperparathyroidism in head and neck tumors.

Abstract

This report presents nine cases of pseudohyperparathyroidism of the head and neck region, as determined by the triad of hypercalcemia, hypophosphatemia, and the absence of significant bone metastases to account for the hypercalcemia. All had serum calcium levels in excess of 11 mg% (normal 9.0-10.5 mg%) at some point during the course of their disease; the serum phosphate was either low or normal as long as the BUN was not elevated. The clinical courses of all nine are summarized. Eight patients were symptomatic with gastrointestinal complaints, confusion, and dehydration. Only one patient responded to therapy with lowering of the serum calcium and relief of symptoms. The hypercalcemia was a terminal event in all cases, appearing 1-11 months prior to death. Eight patients had postmortem examinations which are summarized. Pseudohyperparathyroidism is not uncommon in advanced stages of head and neck cancer, and the consequent symptoms must not be attributed to side effects of the treatments for the widespread tumor. The treatment should be aimed at symptomatic relief.