[Show abstract][Hide abstract] ABSTRACT: We report an interesting case of a 47-yr-old who had a large goiter and multiple rib tumors. The patient was initially suspected
of having thyroid cancer, which had metastasized on the ribs, based on imaging studies. However, laboratory tests revealed
a high level of ionized calcium and parathyroid hormone (PTH). The large goiter was diagnosed as having parathyroid tumors
owing to the high level of PTH in the tissue fluid. The biopsy specimen from a rib tumor was diagnosed as containing brown
tumors associated with primary hyperparathyroidism (PHP). The patient also had prolactinoma and pancreatic gastrinoma. Her
daughter had both prolactinoma and PHP, and her brother and her father had PHP. Thus, the patient was diagnosed as having
multiple endocrine neoplasia type 1.