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Parathyroid adenoma

Wouter A M Broos, Friso M van der Zant, Remco J J Knol, Maurits Wondergem
One of the most promising imaging techniques in primary hyperparathyroidism is PET/CT with choline-based tracers. To investigate the current evidence of these tracers in localizing parathyroid adenoma, a systematic review was performed. A comprehensive literature search was carried out and eligible studies were analyzed. Data were extracted, the level of evidence was scored, and performance data were pooled to calculate the weighted detection rate. Eleven articles were included in this study. The pooled detection rate was 97 and 94% on per patient-based and per lesion-based analysis, respectively...
November 15, 2018: Nuclear Medicine Communications
Jan Laco, Ondřej Daum, Iva Zambo, Ondrej Ondič, Marián Švajdler
In this article, indications and pitfalls in frozen section diagnosis in selected organs and systems are discussed. The main indications for frozen section examination of head and neck and genitourinary system lesions are to evaluate the resection margin and the metastatic involvement of lymph nodes. Recently, intraoperative consultation has been introduced for identification of patients who might benefit from testis-sparing surgery. Preoperative fine-needle aspiration has greatly diminished the need for frozen section evaluation of thyroid lesions...
2018: Ceskoslovenská Patologie
Raoul Verzijl, Pim J Bongers, Geetha Mukerji, Ozgur Mete, Karen M Devon, Jesse D Pasternak
A 71-year-old man with known history of atrial fibrillation (treated with routine rivaroxaban therapy) was found to have incidental biochemical elevated calcium and parathyroid hormone (PTH) levels. His physical examination demonstrated the presence of a palpable right neck mass. Subsequent imaging studies revealed a large parathyroid mass as well as multiple bone lesions, raising the suspicion of parathyroid carcinoma. The anticoagulant therapy was stopped 5 days prior to his elective surgery. The night before his elective surgery, he presented to the emergency room with profound hypocalcemia...
2018: Case Reports in Surgery
Harkamal Singh, Daniel J Wale, Ka Kit Wong, Milton D Gross, Benjamin L Viglianti
In addition to nuclear cardiac and breast imaging, Tc-sestamibi sestamibi scintigraphy is often used to localize parathyroid adenomas. F fluorodeoxyglucose (FDG) PET is heavily utilized in oncology, although its use in identifying parathyroid adenomas is limited. We describe a case of a 57-year-old woman who underwent parathyroid scintigraphy and F-FDG PET/CT in the same week due to hyperparathyroidism and an enlarging breast mass, respectively. A right paratracheal mediastinal mass that otherwise would be suspicious for nodal metastases by CT alone was correctly identified to be an ectopic parathyroid adenoma using a combination of the nuclear medicine studies performed...
November 10, 2018: Clinical Nuclear Medicine
Ioannis Mantzoros, Despoina Kyriakidou, Konstantinos Galanos-Demiris, Christos Chatzakis, Styliani Parpoudi, Nikolaos Sapidis, Lydia Loutzidou, Orestis Ioannidis, Stamatis Angelopoulos, Konstantinos G Tsalis
BACKGROUND Solitary parathyroid adenomas are the leading cause of primary hyperparathyroidism in 0% to 85% of cases. Diagnosis of parathyroid adenoma is based on typical clinical presentation of hypercalcemia, biochemical profile, and modern imaging studies. The purpose of this article is to present the diagnostic and therapeutic approach used for a 73-year-old female patient with a giant parathyroid adenoma measuring 5×2.5×2.5 cm and weighing 30 grams. CASE REPORT A 73-year-old female was referred to the outpatient clinic of our Surgical Department with the diagnosis of primary hyperparathyroidism...
November 8, 2018: American Journal of Case Reports
Xiang Zhang, Ya Hu, Mengyi Wang, Ronghua Zhang, PeiPei Wang, Ming Cui, Zhe Su, Xiang Gao, Quan Liao, Yupei Zhao
Parathyroid carcinoma (PCa) is a rare endocrine neoplasia that typically has unfavourable outcomes. The contribution of long non-coding RNAs (lncRNAs) to the development of malignant and benign parathyroid tumours remains largely unknown. In this study, we explored transcriptomic profiling of lncRNA and mRNA expression in 6 PCa, 6 parathyroid adenoma (PAd) and 4 normal parathyroid (PaN) tissues. In total, 2641 lncRNA transcripts and 2165 mRNA transcripts were differentially expressed between PCa and PAd. Enrichment analysis demonstrated that dysregulated transcripts were involved mainly in the extracellular matrix (ECM)-receptor interaction and energy metabolism pathways...
November 1, 2018: Endocrine-related Cancer
Zhen Zeng, Hu Liao, Feng Luo, Feng Lin
No abstract text is available yet for this article.
November 6, 2018: QJM: Monthly Journal of the Association of Physicians
Kate E Lines, Paul J Newey, Christopher J Yates, Mark Stevenson, Rebecca Dyar, Gerard V Walls, Mike R Bowl, Rajesh V Thakker
Multiple Endocrine Neoplasia type 1 (MEN1) is an autosomal dominant disorder characterised by the combined occurrence of parathyroid, pituitary and pancreatic islet tumours, and is due to mutations of the MEN1 gene, which encodes the tumour suppressor protein menin. Menin has multiple roles in genome stability, transcription, cell division and proliferation, but its mechanistic roles in tumourigenesis remain to be fully elucidated. MicroRNAs (miRNA) are non-coding single stranded RNAs that post-transcriptionally regulate gene expression and have been associated with tumour development, although the contribution of miRNAs to MEN1-associated tumourigenesis and their relationship with menin expression are not fully understood...
September 1, 2018: Journal of Endocrinology
Rakhee Vatsa, Raman Kumar Joshi, Jaya Shukla, Bhagwant Rai Mittal
Choline is a natural substrate for phospholipid synthesis. F-18 labeled fluorocholine nowadays is routinely used for imaging brain tumors, parathyroid adenoma, and prostate cancer. It is synthesized through nucleophilic substitution reaction using dibromomethane and N, N-dimethylaminoethanol as primary and secondary precursors, respectively. However, sometimes, failures are encountered in F-18 fluorocholine production. Few problems and troubleshooting during synthesis are discussed here.
October 2018: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
Lihua Wang, Yuzhu Jia, Guangzhao Yang, Guoqun Mao, Yougen Cheng, Yulin Cao
RATIONALE: Primary hyperparathyroidism (PHPTI) with respiratory tract symptom is extremely rare. It is caused by autonomic oversecretion of parathyroid hormone (PTH) owing to parathyroid adenoma, hyperplasia, or tumor. The diagnosis of PHPTI often needs to be made based on medical history, clinical manifestation, laboratory tests, and imaging examination. Moreover, no study has reported PHPTI with diffuse metastatic pulmonary calcification (MPC) as the characteristic. PATIENT CONCERNS: A 49-year-old female from Zhejiang, China, had a fever of unknown origin, cough with white crude sputum, and asthma after activity for 1 month...
November 2018: Medicine (Baltimore)
Santosh Kumar, Abhishek Chandna, Ashish Khanna, Kalpesh M Parmar, Tushar Aditya Narain, Nripesh Sadasukhi
A 33-year-old female presented to the emergency department of our hospital with urosepsis and hematuria with clot retention secondary to a complicated pyelolithotomy for left-sided pelvic calculus. A percutaneous nephrostomy was placed for drainage as a DJ stent could not be traversed into the left renal pelvis with retrograde pyelography demonstrating complete cut-off at L4-L5 level. After stabilization, she was found to have uretero-pelvic junction obstruction (UPJO) in left solitary functioning kidney with long-segment upper ureteric stricture and nadir serum creatinine 1...
October 31, 2018: Journal of Robotic Surgery
Manish R Balwani, Amit Pasari, Amol Meshram, Anil Jawahirani, Priyanka Tolani, Hansini Laharwani, Charulata Bawankule
Primary hyperparathyroidism (PHPT) usually presents with hypercalcemia related symptoms and signs. Kidneys play an important role in calcium homeostasis. PHPT has been reported to be associated with hyperchloremia, defective urinary acidification, and renal tubular acidosis (RTA). The dysfunction of distal renal tubules is proposed to be secondary to calcium deposition in distal tubules. This case report highlights an initial presentation of parathyroid adenoma as hypokalemia due to distal RTA secondary to medullary nephrocalcinosis...
September 2018: Saudi Journal of Kidney Diseases and Transplantation
C Christofer Juhlin, Robert Bränström, Ivan Shabo, Anders Höög
Follicular neoplasms of the thyroid gland are most often characterized by follicular-patterned thyrocytes with a neutrally stained cytoplasm, while a minority of cases present with oncocytic differentiation (Hürthle cell tumors). Exceedingly rare variants with a clear cell phenotype have also been reported, both as clear cell follicular thyroid adenomas (ccFTAs) and clear cell follicular carcinomas (ccFTCs). We present a patient with a 30-mm lesion in the thyroid isthmus in which the preoperative cytology proposed a follicular tumor...
October 29, 2018: International Journal of Surgical Pathology
Rachelle A LeBlanc, Andre Isaac, Jonathan Abele, Vincent L Biron, David W J Côté, Matthew Hearn, Daniel A O'Connell, Hadi Seikaly, Jeffrey R Harris
BACKGROUND: Accurate localization of parathyroid adenomas is of critical importance in surgical planning for minimally invasive parathyroidectomy. SPECT/CT is considered the investigation of choice but has limitations regarding localization of superior versus inferior adenomas. We proposed a novel method for localization using SPECT/CT by determining the anterior-posterior relationship of the adenoma to a horizontal line in the coronal plane through the tracheoesophageal groove. Our objective was to determine the accuracy, validity, and inter-rater reliability of this method...
October 26, 2018: Journal of Otolaryngology—Head & Neck Surgery
Francesca Marini, Francesca Giusti, Francesco Tonelli, Maria Luisa Brandi
Multiple Endocrine Neoplasia Type 1 (MEN1) is a rare inherited endocrine tumor syndrome principally affecting parathyroid glands, neuroendocrine tissues of the gastro-entero-pancreatic and thoracic tracts, and anterior pituitary, caused by germline inactivating mutations of the MEN1 tumor suppressor gene. Primary hyperparathyroidism (PHPT) is usually the first clinical manifestation of the syndrome, normally manifesting during the third decade of life. Cases of affected children and adolescents have been described by the age of 5...
2018: Frontiers in Endocrinology
Lingqiong Meng, Shuying Liu, Aseel Al-Dayyeni, Zhifeng Sheng, Zhiguang Zhou, Xiangbing Wang
Purpose: To compare the initial clinical features, laboratory values, and bone mineral density among patients with primary hyperparathyroidism (PHPT) in Changsha (China) and New Brunswick (USA). Methods: In this retrospective study, we reviewed 169 PHPT patients who presented at Robert Wood Johnson University Hospital and 133 PHPT patients who presented at the Second Xiangya Hospital of Central South University in the same time period. The following characteristics were compared between the groups: age, gender, BMI, serum calcium, alkaline phosphatase (AKP), albumin, intact PTH (iPTH), 25-hydroxyvitamin D (25 (OH) D), fasting blood glucose levels, and bone mineral density (BMD)...
2018: International Journal of Endocrinology
Alisha Kapur, Narendra Singh, Ozgur Mete, Robert A Hegele, I George Fantus
Hyperparathyroidism, commonly observed in asymptomatic middle-aged women, with mild hypercalcemia, is usually caused by a benign adenoma. Some cases present with more severe manifestation and greater hypercalcemia. Within this spectrum, several familial/genetic associations have been discovered. While the majority are caused by benign disease, adenomas, or hyperplasia, a small proportion (< 1%) are associated with malignant tumors and present with more severe symptoms. Although usually sporadic, recent reports document various gene mutations that strongly predispose to the development of parathyroid carcinoma...
December 2018: Endocrine Pathology
Natascha Platz Batista da Silva, Ernst Michael Jung, Friedrich Jung, Hans J Schlitt, Matthias Hornung
AIM: Aim of this study was to firstly describe reproducible, objective perfusion parameters of contrast-enhanced ultrasound (CEUS) kinetics of parathyroid gland adenoma (PA) using perfusion analysis software (VueBox®, Bracco, Italy). Thereby the efficiency of quantitative CEUS for characterization of PA should be evaluated comparing US to postoperative histopathological findings after PA resection. MATERIAL AND METHODS: 42 patients with symptoms/lab work suggestive of pHPT presented a parathyroid gland lesion in B-mode US, which was consequently analyzed by dynamic CEUS...
October 15, 2018: Clinical Hemorheology and Microcirculation
Francesco Quaglino, Valentina Marchese, Riccardo Lemini, Alessandro Piovesan, Enrico Mazza, Tiziana Viora, Stefano Taraglio
INTRODUCTION: Parathyroid carcinoma (PC) is a slow-growing and very rare malignancy, representing less than 0.005% of all cancers. The rarity of PC makes it hard to create large-scale published series of patients affected by this condition. MATERIALS AND METHODS: We present four cases of PC treated in our Institution and analyze the most salient aspects of this disease highlighted in recent international literature. DISCUSSION AND COMMENTS: In our experience, in 3/4 cases, the clinical presentation of PC was not different compared to adenoma; therefore, the diagnosis was a post-operative histopathological surprise...
2018: Annali Italiani di Chirurgia
Francesco Quaglino, Valentina Marchese, Riccardo Lemini, Alessandro Piovesan, Enrico Mazza, Tiziana Viora, Stefano Taraglio
INTRODUCTION: Parathyroid carcinoma (PC) is a slow-growing and very rare malignancy, representing less than 0.005% of all cancers. The rarity of PC makes it hard to create large-scale published series of patients affected by this condition. MATERIALS AND METHODS: We present four cases of PC treated in our Institution and analyze the most salient aspects of this disease highlighted in recent international literature. DISCUSSION AND COMMENTS: In our experience, in 3/4 cases, the clinical presentation of PC was not different compared to adenoma; therefore, the diagnosis was a post-operative histopathological surprise...
June 11, 2018: Annali Italiani di Chirurgia
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