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Parathyroid adenoma

Thomas Muelleman, Sreeya Yalamanchali, Yelizaveta Shnayder
Parathyroid glands undergo a variable descent during embryologic development and can be found anywhere in the neck from the level of the mandible to the mediastinum. To the best of our knowledge, we present the first report of a patient who was found to have bilateral parathyroid adenomas in her pyriform sinuses. A middle-aged woman with renal failure and secondary hyperparathyroidism presented with dysphagia and was found to have bilateral pyriform sinus masses on endoscopy. We performed direct laryngoscopy and surgical excision of these masses, and they were found to be parathyroid adenomas...
March 2018: Ear, Nose, & Throat Journal
Way Chiang, Zofia Tynski
Angiosarcoma is a rare vascular soft tissue tumor of endothelial origin most commonly seen in the elderly as a primary cutaneous head and neck malignancy. Furthermore, a peritoneal angiosarcoma is an exceedingly rare entity. This is the second case of primary peritoneal angiosarcoma reported in literature that is not associated with prior radiotherapy. Herein, we describe a case of primary peritoneal angiosarcoma metastatic to both the liver and bone in a male patient with metachronous renal cell carcinoma and parathyroid adenoma...
2018: Case Reports in Pathology
Léopoldine Bricaire, Capucine Richard, Mathieu Gauthé, Béatrix Cochand-Priollet, Sébastien Gaujoux
We present the case of a severe familial primary hyperparathyroidism related to a germline deletion in the HRPT2 (CDC73) gene. Morphological explorations revealed 2 potential hyperfunctioning parathyroid glands: a left cervical lesion on the neck ultrasound, and an ectopic mediastinal lesion on the parathyroid scintigraphy using Tc-methoxyisobutylisonitrile and on F-fluorocholine PET/CT. Surgery removal and histopathological examination determined that the mediastinal mass corresponded to a thymoma and the cervical lesion to a parathyroid adenoma...
March 13, 2018: Clinical Nuclear Medicine
P F Alesina, B Meier, J Hinrichs, W Mohmand, M K Walz
PURPOSE: Visualization and precise dissection of the parathyroid glands are a crucial step of thyroidectomy. Moreover, identification of parathyroid adenoma in patients with primary hyperparathyroidism can be challenging due to the possible abnormal location of the enlarged parathyroid. Near-infrared fluorescence (NIR) can be adopted during video-assisted neck surgery in addition to standard endoscopic magnification to enhance the visualization of the parathyroid tissue. METHODS: Between July and August 2017, five patients (one male, four females) underwent video-assisted neck surgery at our hospital...
March 13, 2018: Langenbeck's Archives of Surgery
Caroline Bachmeier, Chirag Patel, Peter Kanowski, Kunwarjit Sangla
Primary hyperparathyroidism (PH) is a common endocrine abnormality and may occur as part of a genetic syndrome. Inactivating mutations of the tumour suppressor gene CDC73 have been identified as accounting for a large percentage of hyperparathyroidism-jaw tumour syndrome (HPT-JT) cases and to a lesser degree account for familial isolated hyperparathyroidism (FIHP) cases. Reports of CDC73 whole gene deletions are exceedingly rare. We report the case of a 39 year-old woman with PH secondary to a parathyroid adenoma associated with a large chromosomal deletion (2...
2018: Endocrinology, Diabetes & Metabolism Case Reports
Danica Popovik-Monevska, Suzana Bozovik-Dvojakovska, Vladimir Popovski, Alberto Benedetti, Aleksandar Grchev, Filip Koneski
BACKGROUND: The hyperparathyroidism (HPT) is a condition in which the parathyroid hormone (PTH) levels in the blood are increased. HPT is categorised into primary, secondary and tertiary. A rare entity that occurs in the lower jaw in association with HPT is the so-called brown tumour, which an osteolytic lesion is predominantly occurring in the lower jaw. It is usually a manifestation of the late stage of the disease. Osteosclerotic changes in other bones are almost always associated with renal osteodystrophy in secondary HPT and are extremely rare in primary HPT...
February 15, 2018: Open Access Macedonian Journal of Medical Sciences
Trine B Andersen, Ramune Aleksyniene, Søren K Boldsen, Michael Gade, Henrik Bertelsen, Lars J Petersen
OBJECTIVE: The aim of this study was to investigate the contribution of contrast-enhanced computed tomography (CE-CT) to the localization of parathyroid adenomas compared with the dual-phase Tc-99m MIBI SPECT with low-dose CT (LD-CT). PATIENTS AND METHODS: This retrospective study included consecutive patients with primary hyperparathyroidism who underwent a preoperative dual-phase MIBI SPECT/CT followed by surgical resection. The standard of care was dual-phase MIBI SPECT/CT, acquired with LD-CT in the early phase and CE-CT in the late phase (SPECT/CE-CT)...
March 6, 2018: Nuclear Medicine Communications
Mohsen Beheshti, Lukas Hehenwarter, Zeinab Paymani, Gundula Rendl, Larisa Imamovic, Rupert Rettenbacher, Oleksiy Tsybrovskyy, Werner Langsteger, Christian Pirich
PURPOSE: In this prospective study we compared the accuracy of18 F-fluorocholine PET/CT with that of99m Tc-MIBI or99m Tc-tetrofosmin SPECT/CT in the preoperative detection of parathyroid adenoma in patients with primary hyperparathyroidism. We also assessed the value of semiquantitative parameters in differentiating between parathyroid hyperplasia and adenoma. METHODS: Both18 F-fluorocholine PET/CT and99m Tc-MIBI/tetrofosmin SPECT/CT were performed in 100 consecutive patients with biochemical evidence of primary hyperparathyroidism...
March 8, 2018: European Journal of Nuclear Medicine and Molecular Imaging
Masaya Ikuno, Takayuki Yamada, Yasumoto Shinjo, Tsuyoshi Morimoto, Reiko Kumano, Kunihiro Yagihashi, Takuyuki Katabami, Yasuo Nakajima
Background: Selective venous sampling (SVS) is an invasive localization study for persistent or recurrent hyperparathyroidism. Purpose: To assess the role of SVS in addition to non-invasive imaging for primary hyperparathyroidism (pHPT). Material and Methods: This study was approved by the institutional review board and included 14 patients who underwent SVS and subsequent parathyroidectomy between January 2014 and April 2017 following a clinical diagnosis of pHPT...
February 2018: Acta Radiologica Open
Abdullah A Alharbi, Fahad M Alshehri, Abdulrahman A Albatly, Bert-Ram Sah, Christoph Schmid, Gerhard F Huber, Martin W Huellner
PURPOSE: The aim of the study was to investigate the relationship between [18 F]fluoromethyl-dimethyl-2-hydroxyethylammonium ([18 F]FCh) positron emission tomography (PET) parameters, laboratory parameters, and postoperative histopathological results in patients with primary hyperparathyroidism (pHPT) due to parathyroid adenomas. PROCEDURES: This retrospective study was conducted in 52 patients with biochemically proven pHPT. [18 F]FCh-PET parameters (maximum standardized uptake value: SUVmax) in early phase (after 2 min) and late phase (after 50 min), metabolic volume, and adenoma-to-background ratio (ABR), preoperative laboratory results (PTH and serum calcium concentration), and postoperative histopathology (location, size, volume, and weight of adenoma) were assessed...
March 5, 2018: Molecular Imaging and Biology: MIB: the Official Publication of the Academy of Molecular Imaging
Israel Ugalde, Manuel Bello Segura, Sabrina Oneto, Ari Ciment
An altered mental status presents a diagnostic challenge for many clinicians. Described here is a case of primary hyperparathyroidism not initially suspected until after a thorough neurological and infectious cause were excluded. A 60-year-old woman presented with altered mental status and gait instability. Her family noticed progressive gait instability and mood swings for the past 4 months. Initial imaging and laboratory values were unable to explain her symptoms. On transfer out of the intensive care unit, her corrected calcium was found to be 13...
March 5, 2018: BMJ Case Reports
R J Egan, H Iliff, M J Stechman, D M Scott-Coombes
BACKGROUND: Parathyroid hormone (PTH) has a short half-life and is cleared by the liver and kidneys. This study examined whether declining estimated glomerular filtration rate (eGFR) affects application of the Miami criterion for intraoperative PTH (ioPTH) decline during parathyroidectomy for primary hyperparathyroidism (pHPT). METHODS: A retrospective review of consecutive patients undergoes parathyroidectomy for pHPT. Patients with multi-gland disease, without ioPTH, failure-to-cure and those <18 years were excluded...
March 1, 2018: World Journal of Surgery
Adriana Handra-Luca, Frederique Tissier
Parathyroid cysts are rare, more frequently functional. Here we report 2 cases of infracentimetric parathyroid cysts identified in parathyroid adenomas resected for hyperparathyroidemia and hypercalcemia. Chronic parathyroiditis was associated. Chromogranin and E-cadherin/uvomorulin were expressed heterogeneously in the cyst lining and in parathyroid cells. In one of the cases, CD10 and CD56 were expressed by the luminal membrane of parathyroid cells. CD31 was expressed in interparathyroid cell monocyte/macrophage membrane as well as CD68, several cells showing also CD10 and/or CD56 expression...
September 28, 2017: Pathology, Research and Practice
Prateush Singh, Yehudit Bauernfreund, Pallavi Arya, Esha Singh, Justin Shute
Primary hyperparathyroidism (PHPT) can cause hypercalcaemia secondary to a pathologically high secretion of parathyroid hormone. Rarely this can first manifest as acute psychosis. It is imperative to exclude organic causes of psychosis before labelling the psychosis as primarily psychological. If hypercalcaemia is revealed, investigation is required to elucidate the underlying cause whilst instigating treatment to lower serum calcium levels. If PHPT is the underlying pathology, subsequent treatment involves surgical exploration and resection of the parathyroid adenoma or hyperplasia...
February 2018: Journal of Surgical Case Reports
Kiyobumi Ota, Sayo Koseki, Kenji Ikegami, Iichiroh Onishi, Hiyoryuki Tomimitsu, Shuzo Shintani
75 years old woman presented with 6-month history of progressive dropped head syndrome. Neurological examination revealed moderate weakness of flexor and extensor of neck and mild weakness of proximal appendicular muscles with normal deep tendon reflexes. The needle electromyography showed short duration and low amplitude motor unit potential. No fibrillation potentials or positive sharp waves were seen. Biopsy of deltoid muscle was normal. Laboratory studies showed elevated levels of serum calcium (11.8 mg/dl, upper limit of normal 10...
February 28, 2018: Rinshō Shinkeigaku, Clinical Neurology
Moska Hamidi, Michael Sullivan, George Hunter, Leena Hamberg, Nancy L Cho, Atul A Gawande, Gerard M Doherty, Francis D Moore, Matthew A Nehs
BACKGROUND: Recurrent primary hyperparathyroidism (PHPT) presents a diagnostic challenge in localizing a hyperfunctioning gland. Although several imaging modalities are available for preoperative localization, 4D-CT is increasingly utilized for its ability to locate both smaller and previously unlocalized lesions. Currently, there is a paucity of data evaluating the utility of 4D-CT in the reoperative setting compared with ultrasound (US) and sestamibi. We aimed to determine the sensitivity of 4D-CT in localizing parathyroid adenomas in recurrent or persistent PHPT...
February 26, 2018: Annals of Surgical Oncology
Adam Stangierski, Kosma Wolinski, Marek Ruchala
PURPOSE: Shear wave elastography (SWE) was described as valuable tool in the diagnostics of distinct types of thyroid lesions, thyroiditis and several other non-thyroidal conditions, such as liver inflammation and fibrosis or diagnostics of breast lesions. The aim of the current study was to assess the appearance of parathyroid adenomas in SWE and to check prospectively if SWE can be valuable additional tool in the diagnostics of pathologically enlarged parathyroids. METHODS: Patients with parathyroid adenomas confirmed by histopathology were included...
February 21, 2018: Endocrine
Ethan Frank, Daniela Ale-Salvo, Joshua Park, Yuan Liu, Alfred Simental, Jared C Inman
BACKGROUND: Thyroid disease occurs more frequently in patients with hyperparathyroidism than the general population and hinders parathyroid localization. Identifying thyroid pathology before operating improves management and avoids the risks of reoperation in the neck. This review assesses imaging studies in patients with hyperparathyroidism and thyroid pathology to identify the ideal imaging methodology for patients with multigland disease. METHODS: Systematic review of original articles reporting sensitivity or positive predictive value (PPV) for one or more imaging modalities in patients with hyperparathyroidism and thyroid disease...
February 20, 2018: Head & Neck
Michael Cordes, Otto Dworak, Thomas Papadopoulos, Stephan Coerper, Torsten Kuwert
PURPOSE: In this study, we tested the hypothesis that MIBI-positive and MIBI-negative adenomas of parathyroid glands (APGs) have distinct biochemical and histological markers that could help differentiate MIBI-positive from MIBI-negative APGs. PATIENTS AND METHODS: 40 patients with 41 APGs were included in the study. Patients were enrolled in the study after MIBI scintigraphy examinations had been carried out. Biochemical analyses included serum levels of calcium (Ca), intact parathyroid hormone (iPTH), and 25-hydroxyvitamin D3 (25-OH-D3)...
February 20, 2018: Endocrine Research
Ya Hu, Xiang Zhang, Ming Cui, Zhe Su, Mengyi Wang, Quan Liao, Yupei Zhao
PURPOSE: Parathyroid carcinoma (PCa) is a rare endocrine malignancy with poor prognosis and is often difficult to accurately diagnose both before and after surgery. Dysregulated microRNA (miRNA) levels have been identified in PCa using a limited number of samples. The aim of the present study was to verify a group of miRNA markers in a new series of samples to explore their potential significance in PCa diagnosis. METHODS: A total of 58 tissue samples, including 17 PCa lesions and 41 sporadic parathyroid adenomas (PAds), were obtained from 56 primary hyperparathyroidism (pHPT) patients...
February 16, 2018: Endocrine
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