Recurrent laryngeal cancer presenting as delayed hypoparathyroidism.

Abstract

Endocrine dysfunction following therapy for head and neck cancer has been previously described. Permanent hypoparathyroidism may result from the tumor, surgery, or radiation therapy. However, the incidence and significance of delayed hypoparathyroidism following treatment for laryngeal cancer remains unclear. We report a patient who had stable serum calcium measurements on serial testing following concurrent chemoradiation and salvage laryngectomy for locally advanced laryngeal cancer. The patient subsequently presented 32 months following salvage laryngectomy with new onset, symptomatic hypocalcemia secondary to hypoparathyroidism. Subsequent evaluation revealed local recurrence. To our knowledge, this case represents the first report of delayed hypoparathyroidism as the presenting manifestation of recurrence following treatment for laryngeal cancer. Possible pathophysiologic mechanisms are discussed.