Iatrogenic hypoparathyroidism – not only after thyroid surgery ...

The most common causes of hypoparathyroidism are iatrogenic: mostly thyroid or parathyroid surgery. Much less frequently HypoPT is caused by an extensive oncological surgical procedure e.g. because of larynx or upper throat cancer, or external neck radiotherapy, e.g. in the case of lymphoma. In those particular cases, both patients and doctors focus their attention on the oncological nature of the disease itself, which often results in neglect of other health hazards, and potentially poor prognosis, and short survival time in those cases additionally mask the problem. However, in individual patients cured from cancer, unrecognized hypoparathyroidism can significantly affect their health and quality of life. Two such cases are presented. To our knowledge, the cases presented by us are the first cases diagnosed after such a long time after laryngectomy or radiation therapy. This may indicate that other patients undergoing such treatment could be exposed to this rare complication as well, regardless of the time that elapsed after the treatment. This implies the need for systematic monitoring of serum calcium, as well as for enhanced diagnosis in the case of even the slightest clinical suspicion of hypoparathyroidism.