Abstract 23: Primary hyperparathyroidism masking hypercalcemia of malignancy: A case report

Primary hyperparathyroidism is the third most common endocrine disease, while association with Non-Hodgkin's Lymphoma is extremely rare. Both conditions can initially present with hypercalcemia. Here we present a case of 62-year-old female with recurrent syncope as initial complaint which was found to be secondary to hypercalcemia. There was elevated PTH, and she underwent parathyroidectomy with good intraop reduction of PTH but still had hypercalcemia. She was lost to follow-up and presented after 2 months with paraplegia. On evaluation she had abnormal cytology that was suggestive of leukemia. Further evaluation with bone marrow biopsy and flow cytometry revealed NHL. Association of nonendocrine cancers with parathyroid tumors is well established though pathogenesis is not yet clear. This emphasizes the importance of postoperative follow-up of primary hyperparathyroidism patients for early detection of associated cancers.