Endocrine Abstracts

JOINT2475

Introduction: Thyroid damage is a complication of total laryngectomy and may be caused by manipulation of the gland. There are isolated descriptions in the literature related to transient hyperthyroidism post-head and neck surgery. Hypercalcemia is an infrequent element in patients with hyperthyrodism. The appearance of a hypercalcemic crisis can trigger serious complications for the patient, being an exceptional event in patients with thyrotoxicosis

Case Report: We report the case of a 58-year-old man who underwent total laryngectomy and left thyroidectomy for a pyriform sinus tumor. Twenty days after the intervention, frank hyperthyroidism was detected (TSH 0.01, FT4 3.34, T3 4.82) with negative thyroid autoimmunity. Concomitantly, hypercalcemia was detected with calcium corrected for albumin of 11.2 and suppressed PTH with a good response to hydration and treatment with glucocorticoids. PTHrp was requested with results within normal limits. After 2 weeks, thyroid function and phosphocalcium metabolism normalized.

Conclusions: Post-laryngectomy thyroiditis has a prevalence of up to 54.6% in some series. Hypercalcemia is an uncommon element in patients with hyperthyroidism, the symptoms overlap with hyperthyroidism and its primary identification requires a high index of suspicion. The appearance of a hypercalcemic crisis can trigger serious complications in the patient, this being an exceptional event in patients with thyrotoxicosis. The hypercalcemia suppression test with steroids is of great clinical utility in its association with thyrotoxicosis to rule out concurrent hyperparathyroidism. We suggest measuring thyroid function and phosphocalic metabolism in the routine analysis of patients undergoing total laryngectomy.