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Parathyroid adenoma

Jianjun Xue, Yan Liu, Ting Ji, Aomei Zhao, Yiqian Liang, Huixing Deng, Qi Wang, Yuemin Zhang, Lulu Yang, Aimin Yang
OBJECTIVE: The aim of this study was to evaluate the value of technetium-99m methoxyisobutylisonitrile (Tc-MIBI) imaging and ultrasound in preoperative localization of parathyroid adenoma (PA) and parathyroid hyperplasia (PH). PARTICIPANTS AND METHODS: A retrospective study of Tc-MIBI double-phase scintigraphy (DPS) was performed in 187 hyperparathyroidism cases with pathologically diagnosed PA or PH. Of these patients, 167 cases underwent ultrasound, and 146 cases underwent Tc-MIBI single-photon emission computed tomography/computed tomography (SPECT/CT)...
September 19, 2018: Nuclear Medicine Communications
Banafsheh Motazedi, Maziar Rahmani, James M Welch, Abbas Motazedi
A 77-year-old woman was diagnosed with pheochromocytoma followed by adrenalectomy at age 57. Hyperparathyroidism without osteoprosis was diagnosed at age 58. At age 75, Dual Energy X-ray Absoptiometry (DEXA) revealed osteoporosis and sestamibi scan showed a left parathyroid adenoma. Criteria for parathyroidectomy were met, and she underwent parathyroidectomy. Furthermore, she presented with haematochezia at age 75. An abdominal CT demonstrated a mass in the second portion of the duodenum. Additionally, octreoscan revealed somatostatin receptor positive tissue in the duodenum and Gallium 68 dotatate scan also showed a well-differentiated duodenal neuroendocrine tumour (NET)...
September 4, 2018: BMJ Case Reports
Meghana Prabhu, Garima Kumari, Nishikant Avinash Damle, Geetanjali Arora, Madhavi Tripathi, Chandrasekhar Bal, Praveen Kumar, Rajeev Kumar
Recent studies have established the superiority of FCH PET/CT over MIBI scan in accurate preoperative localization of parathyroid adenomas. In this patient, we compared both early dynamic and conventional static imaging to see if early imaging could suffice. We describe a 15-year-old boy with primary hyperparathyroidism, in whom early dynamic FCH PET/CT was performed for 15 minutes after injection, followed by conventional static image at 60 minutes. Early dynamic images accurately localized the parathyroid adenoma...
August 31, 2018: Clinical Nuclear Medicine
Meghana Prabhu, Nishikant A Damle
To give an overview of the potential clinical utility of 18F-fluorocholine PET/CT (FCH PET/CT) in imaging of parathyroid adenoma. Available studies have provided preliminary results of 18F-FCH PET/CT in primary and secondary hyperparathyroidism. Results of various studies have shown that 18F-FCH is a promising upcoming tracer for the detection of parathyroid adenomas, especially when multiple, or having low size. FCH PET/CT has the potential to be a standard investigation in the detection of parathyroid lesions...
July 2018: Indian Journal of Endocrinology and Metabolism
Philip Touska, Alison Elstob, Nikhil D Rao, Arum Parthipun
Rationale: To evaluate the accuracy of one-stop (single patient attendance) SPECT-CT-guided ultrasound (US) in the localisation of parathyroid adenomata (PTA). Secondary aims included analysing the effect of multiple PTA and concurrent thyroid disease on sensitivity. Methods: Patients with hyperparathyroidism that had undergone parathyroidectomy were identified over a 5 year period. Pathological correlation with results from pre-operative sestamibi SPECT-CT followed by targeted US of the neck was performed...
August 23, 2018: Journal of Nuclear Medicine Technology
Mine Araz, Çiğdem Soydal, Elgin Özkan, Metin K Kir, Erkan İbiş, Sevim Güllü, Murat F Erdoğan, Rifat Emral, Özlem N Küçük
AIM: The aim of this study was to determine the role of fluorine-18-choline (F-FCH) PET/CT in comparison with technetium-99m-methoxyisobutylisonitrile (Tc-MIBI) single-photon emission computed tomography/computed tomography (SPECT/CT) in primary hyperparathyroidism and to investigate whether maximum standardized uptake value (SUVmax) may be indicative of disease severity. PATIENTS AND METHODS: Thirty-five primary hyperparathyroidism patients (24 females, 11 males, mean age: 55...
August 22, 2018: Nuclear Medicine Communications
Elisabeth Maurer, Sabine Wächter, Katharina Holzer, Detlef K Bartsch
BACKGROUND: In the recent years, targeted surgery, especially minimally invasive parathyroidectomy, has become the procedure of choice to treat sporadic primary hyperparathyroidism (pHPT) and is performed after preoperative standardised, accurate and reliable localisation. The intraoperative quick parathyroid hormone (qPTH) test is considered as a condition for successful resection of the parathyroid adenoma. The intraoperative qPTH test prolongs surgery and anaesthesia. The aim of this study was to evaluate whether there are disadvantages if patients do not wait for the qPTH result before terminating the procedure...
August 2018: Zentralblatt Für Chirurgie
Ya Hu, Ming Cui, Yu Xia, Zhe Su, Xiang Zhang, Quan Liao, Yuxin Jiang, Yupei Zhao
Objective: Cystic parathyroid adenoma is a rare cause of primary hyperparathyroidism, but its preoperative diagnosis and management remain inconclusive. Method: We retrospectively identified patients with cystic parathyroid adenomas who underwent surgery at Peking Union Medical College Hospital. Results: Patients with cystic parathyroid adenomas had higher serum intact parathyroid hormone and calcium levels, larger maximum tumor diameter, and lower serum inorganic phosphorus level than did those with solid adenomas...
2018: International Journal of Endocrinology
S Theurer, U Siebolts, K Lorenz, H Dralle, K W Schmid
Ectopic thyroid tissue results from developmental defects of the early stages of thyroid embryogenesis, in which the median thyroid anlage descends from the floor of the mouth to its final pre-tracheal position. The most common sites of ectopic thyroid tissue are accordingly in the area of the floor of the mouth and in the course of the thyroglossal duct. Rare localizations are intrathoracic (mediastinal, cardiac, pulmonary) and sub-diaphragmatic (including the adrenals, liver, gall bladder, and gastrointestinal tract)...
September 2018: Der Pathologe
Hassan Al-Thani, Moamena El-Matbouly, Maryam Al-Sulaiti, Mohammad Asim, Ahmad Majzoub, Abdelhakem Tabeb, Ayman El-Menyar
Background: Hyperparathyroidism is a frequent endocrine disorder with variable clinical manifestations and outcomes. We aimed to evaluate clinical presentations, management and outcomes of hyperparathyroidism. Methods: A retrospective study was conducted to include all patients presented with hyperparathyroidism between 1995 and 2014 at a single tertiary hospital with an average follow-up period of 46 months. Data were reviewed for clinical presentations, diagnostic work-up, intraoperative findings, management, and outcomes...
2018: Therapeutics and Clinical Risk Management
Sagit Stern, Sharon Tzelnick, Aviram Mizrachi, Maya Cohen, Thomas Shpitzer, Gideon Bachar
Objectives Ultrasonography (US) is a reliable tool for the preoperative localization of parathyroid adenomas (PTAs). The aim of this study was to evaluate the accuracy of US for estimating both the size and the location of PTAs and the effect of operator expertise. Study Design Retrospective cohort study. Setting A single tertiary medical center. Subjects and Methods All patients who underwent parathyroidectomy for primary hyperparathyroidism between 1996 and 2012 were included. The estimated PTA localization and size by preoperative ultrasound were compared with the intraoperative findings and pathology report...
August 14, 2018: Otolaryngology—Head and Neck Surgery
I Bossert, S Chytiris, M Hodolic, L Croce, L Mansi, L Chiovato, G Mariani, G Trifirò
PURPOSE: Identification of pathologic parathyroid glands in primary hyperparathyroidism, traditionally based on neck ultrasound (US) and/or 99m Tc-Sestamibi scintigraphy, can be challenging. PET/CT with 18 F-Fluorocholine (18 F-FCH) might improve the detection of pathologic parathyroid glands. We aimed at comparing the diagnostic performance of 18 F-FCH-PET/CT with that of dual-phase dual-isotope parathyroid scintigraphy and neck US. METHODS: Thirty-four consecutive patients with primary hyperparathyroidism were prospectively enrolled, 7 had normocalcemic hyperparathyroidism, and 27 had classic hypercalcemic hyperparathyroidism...
August 9, 2018: Journal of Endocrinological Investigation
Gnanaselvam Pamathy, Umesh Jayarajah, Tshering Wangmo, Anura S K Banagala
Lithium induced primary hyperparathyroidism is an uncommon endocrine side effect of long term lithium therapy. We studied the case of a 67-year-old female patient on long term lithium therapy for bipolar affective disorder, who developed resistant hypercalcaemia and parathyroid adenoma which required parathyroidectomy. Furthermore, the effect of chronic lithium therapy on parathyroid glands and serum calcium levels, its pathogenesis, and management were reviewed. Periodic monitoring of serum calcium levels in patients on long term lithium therapy should be practiced...
July 2018: Indian Journal of Psychological Medicine
V J Mallikarjuna, Vivek Mathew, Vageesh Ayyar, Ganapathy Bantwal, V Ganesh, Belinda George, G N Hemanth, P Vinotha
Background: Primary hyperparathyroidism (PHPT) is a common endocrine disease with a variable clinical presentation. PHPT is usually symptomatic at presentation in majority of the patients, especially in developing countries. As the accessibility to investigations, advanced imaging methods and surgical procedures are improving, the clinical profile of the patients with PHPT has undergone a palpable change compared to the earlier description. Hence we decided to look for a change in clinical, imaging and surgical outcomes of PHPT patients from South India...
May 2018: Indian Journal of Endocrinology and Metabolism
Jasmine Sethi, Vivek Kumar, Manish Rathi, Krishan Lal Gupta
Parathyroid or hypercalcaemic crisis is a rare presenting manifestation of primary hyperparathyroidism and usually seen in relation to parathyroid carcinoma and multiple myeloma. We present a middle-aged woman with extreme hypercalcaemia due to parathyroid adenoma presenting as acute kidney injury. This case highlights the need to consider primary hyperparathyroidism in differentials of a patient presenting with severe hypercalcaemia and renal dysfunction. Also this is the second reported case in literature of a patient surviving such extreme hypercalcaemia due to parathyroid adenoma...
July 30, 2018: BMJ Case Reports
Turker Yucesoy, Erdem Kilic, Fatma Dogruel, Fahri Bayram, Alper Alkan, Alper Celal Akcan, Figen Ozturk
Primary hyperparathyroidism is an endocrine disorder occurring due to increased secretion of parathormone resulting in a complex of clinical, anatomical, and biochemical alterations. On the other hand, excision of a parathyroid adenoma can normalize the metabolic status. A 24-year-old man was referred to the hospital with bilateral swelling and spontaneous gingival bleeding from posterior of the mandible also with radiolucent well-demarcated lesions bilaterally in the mandibular third molar regions. After consultations, the patient was hospitalized in the endocrinology department where further tests were performed due to highly increased PTH level as 714 pg/ml...
2018: Case Reports in Dentistry
Halil Komek, Edip Erdal Yilmaz, Bahri Cakabay, Serdar Altindag, Nilufer Ozdemir, Canan Can, Ferat Kepenek
OBJECTIVE: The aim of the present study was to compare the surgical results with contrast-enhanced [99mTc] MIBI SPECT/CT results by adding the simultaneous single phase contrast to the [99mTc] MIBI SPECT/CT examination. METHOD: Between November 2016 and January 2018, 24 (21 female, 3 male) patients who underwent an operation after preoperative contrast-enhanced [99mTc]MIBI SPECT/CT, and 49 asymptomatic patients (42 female, 7 male), who did not undergo surgery, were included in the study...
July 23, 2018: Annali Italiani di Chirurgia
Akinori Kanzaki, Kiyoshi Matsui, Tadahiko Sukenaga, Koushi Mase, Aya Nishioka, Tomoharu Tamori, Seiko Kataoka, Hiroyuki Konya, Shin Mizutani, Akira Takeda, Masato Koseki, Tetsuo Nishiura, Hidenori Koyama, Hajime Sano
Polymyalgia rheumatica (PMR) is a disease commonly seen in elderly individuals, however, the etiology has not been reported. Typical clinical features include bilateral shoulder pain and morning stiffness, while serologic autoantibody test findings are negative. Approximately 40%-50% of affected patients present with low-grade fever, fatigue, and appetite loss, which we often experience in the field of general medicine, and thus, the condition should not be given low priority. However, knowledge regarding such constitutional manifestations is also limited...
2018: International Journal of General Medicine
Alyssa R Goldbach, Simin Dadpravarar
No abstract text is available yet for this article.
July 23, 2018: Endocrine Practice
Hany Abdelfatah El-Hady, Hisham Saleh Radwan
Background: Single parathyroid adenoma is the commonest cause of primary hyperparathyroidism. Localization of the affected gland preoperatively is a critical step in management. Surgery is considered as the main line of treatment for single parathyroid adenoma. Focused technique for parathyroid excision was found by many researchers to have a good success rate even without intraoperative parathyroid hormone measurement. Objective: The aim of this study was to assess the feasibility, safety, and adequacy of focused parathyroidectomy via an open lateral approach using preoperative positive Sestamibi (MIBI) scan and/or ultrasound without utilizing any intraoperative aiding tools...
June 2018: Electronic Physician
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