Primary Hyperparathyroidism Associatiated with Aldosterone-Producing Adrenocortical Adenoma and Breast Cancer : Relation to MEN1 Gene
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概要
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A rare case of primary hyperparathyroidism associated with primary aldosteronism and breast cancer is reported. A 44-year-old woman was admitted to our hospital to undergo surgical removal of breast cancer. She had hypertension with low serum potassium, and slightly but significantly elevated serum calcium levels. Further studies demonstrated an enlarged left superior parathyroid gland and a left aldosterone-producing adrenocortical adenoma. Blood pressure was controlled with spironolactone and nifedipine, and left mastectomy was done for breast cancer. The pathological diagnosis was scirrhous breast carcinoma. Although the postoperative course was uneventful, her serum calcium gradually and progressively rose to higher levels. Left superior parathyroidectomy and left adrenalectomy were then performed simultaneously. The pathological diagnoses of the resected parathyroid gland and adrenal gland were parathyroid chief cell adenoma and adrenocortical adenoma with hyperplasia of zona glomerulosa, respectively. To clarify if the occurence of these tumors may be related to MEN1 gene mutations, we analyzed MEN1 gene in this patient, and found a loss of heterozygosity of the MEN1 locus in the parathyroid adenoma and breast cancer. Thus, we conclude that an alteration of the MEN1 gene and/or another tumor suppressor gene located at the MEN1 locus on chromosome 11q13 may be responsible for the development of parathyroid adenoma and breast cancer in our patient suggesting that the clinical spectrum of MEN1 might include breast cancer. In addition, serum calcium should be interpreted with caution in primary aldosteronism, because hypercalcemia may be masked in the presence of aldosterone excess.
- 2004-04-01
著者
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TSUKADA Toshihiko
Growth Factor Division National Cancer Center Research Institute
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YAMAGUCHI Ken
Growth Factor Division National Cancer Center Research Institute
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Yamaguchi Ken
Growth Factor Division National Cancer Research Institute
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Honda Munehiro
Fourth Department Of Medicine Teikyo University School Of Medicine
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Yamazaki K
Kanaji Hospital Tokyo Jpn
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MIYAKAWA Hiroshi
Fourth Department of Internal Medicine, Teikyo University School of Medicine
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OBARA TAKAO
Department of Endocrine Surgery, Tokyo Women's Medical University
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Obara T
Department Of Endocrine Surgery Tokyo Women's Medical University
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Obara T
Department Of Endocrine Surgery Tokyo Women's Medical College
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Obara Takao
Department Of Endocrine Surgery Tokyo Women's Medical College
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Okamoto T
Department Of Endocrine Surgery Tokyo Women's Medical University
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Yamaguchi Ken
帝京大学 医学部第四内科学
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ISHIBASHI Miyuki
Fourth Department of Internal Medicine, Teikyo University School of Medicine
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TANAKA Reiko
Department of Infections, Research Center for Pathogenic Fungi and Microbial Toxicoses, Chiba Univer
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Ishibashi Miyuki
Fourth Department Of Internal Medicine Teikyo University Mizonokuchi Hospital
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Tsukada Toshihiko
Growth Factor Division National Cancer Research Institute
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Obara T
Department Of Surgery Institute Of Clinical Endocrinology Tokyo Women's Medical University
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Miyakawa Hiroshi
Fourth Department Of Internal Medicine Teikyo University Mizonokuchi Hospital
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Tsukada Teruyo
Growth Factor Division National Cancer Research Institute
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HORIUCHI Toshimitsu
Fourth Department of Medicine, Teikyo University School of Medicine
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Yamazaki Kiyomi
Growth Factor Division National Cancer Research Institute
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Miyakawa Hiroshi
Fourth Department Of Medicine Teikyo University School Of Medicine
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Tanaka Reiko
Department Of Surgery Institute Of Clinical Endocrinology Tokyo Women's Medical College
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Tanaka Reiko
Department Of Endocrine Surgery Tokyo Women's Medical College
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Horiuchi Toshimitsu
Fourth Department Of Medicine Teikyo University School Of Medicine
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ISHIBASHI Miyuki
Fourth Department of Medicine, Teikyo University School of Medicine
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