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Parathyroid adenoma

Cheng Fang, Eleni Konstantatou, Nicola J Mulholland, Serena Baroncini, Mohammad A Husainy, Klaus-Martin Schulte, Paul S Sidhu
Purpose: To identify the variant features encountered in parathyroid abnormalities and document those suggesting malignant change. Materials and methods: Data were collected from a cohort of patients who underwent investigation for primary hyperparathyroidism over a 10-year period. Ultrasonographic features: shape, presence of calcification, cystic changes, heterogeneous echogenicity, vascularity, capsular thickening, local invasion, and vascularity were reviewed retrospectively and were used to correlate with final histological findings...
May 2018: Ultrasound: Journal of the British Medical Ultrasound Society
I Bombil, L Louw, C Mitchell, F Mahlobo, R A Muganza, N R Madima
BACKGROUND: Presentation of hyperparathyroidism varies and is highly non-specific. The automated calcium analyzer has made the diagnosis easy. Similarly, the advent of Sestamibi scan has paved the way to minimally invasive parathyroidectomy indicated for parathyroid adenoma. There is no uniformity in the extent of minimally invasive parathyroidectomy that is done through limited incision under radio or sonar guidance and endoscopically. In this study, we are presenting the focused parathyroidectomy performed under sonar guidance and superficial cervical block (SCB)...
June 2018: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
Asena Gökçay Canpolat, Mustafa Şahin, Elif Ediboğlu, Murat Faik Erdoğan, Sevim Güllü, Özgür Demir, Rıfat Emral, Demet Çorapçioğlu
INTRODUCTION: Minimally invasive surgery is an alternative surgical approach for primary hyperparathyroidism with less surgical trauma and anesthesia complications. When combined with intraoperative measurement of parathyroid hormone (PTH), cure rates are exceeding 97%. Preoperative intact PTH determination in washout samples is really very useful when parathyroid lesions can not be easily distinguished from thyroid lesions or sometimes lymph nodes. Herein, we aimed to report our institutional experience about parathyroid fine needle aspiration (FNA) method and suggest a cut-off ratio for this purpose...
July 13, 2018: Clinical Endocrinology
Virgilijus Beiša, Neringa Pranskevičiūtė, Gabija Makūnaitė, Kęstutis Strupas
Primary hyperparathyroidism is overproduction of parathyroid hormone, causing hypercalcemia. Parathyroid adenomas have been found to be the etiology for 80% of cases of primary hyperparathyroidism, while almost a quarter of them are ectopic. We present a case of ectopic thymic parathyroid adenoma, treated by the thoracoscopic approach. Preoperative computed tomogram and technetium-99-sestamibi imaging showed an adenoma, located in the front mid-mediastinum, approximately 8 × 10 mm in size. Resection of the tumor was indicated according to the persistent hypercalcemia after unsuccessful surgical treatment performed 3 years ago...
June 2018: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
Owen Alvine, Gregory Alvine
We present a case of osteitis fibrosa cystica (OFC), also known as "brown tumor." A 55-year old female was admitted to the hospital with several months of right hip pain that was becoming more severe. A malignant lesion of the pelvis was suspected after initial imaging studies. Significant hypercalcemia led to a diagnosis of hyperparathyroidism and ultimately a benign parathyroid adenoma. Surgical excision of the adenoma resulted in full resolution of the tumor in her pelvis as well as her pain. It is important to keep OFC, or brown tumor, in your differential diagnoses when presented with a bone lesion...
April 2018: South Dakota Medicine: the Journal of the South Dakota State Medical Association
Can Pang, Youben Fan, Huizheng Zhang, Haoyong Yu, Bomin Guo, Jie Kang, Xianzhao Deng, Yuqian Bao
RATIONALE: Parathyroid hormone PTH) levels are the main parameters to differentiate primary hyperparathyroidism (PHPT) from non-PTH-dependent hypercalcemia. We report a case of hypercalcemia with normal PTH levels due to a parathyroid adenoma. PATIENT CONCERNS: A 52-year-old female patient presented with 2-year history of documented sustained high-normal serum calcium and hypercalcemia (2.51-3.03 mmol/L) with normal serum intact PTH levels (21.95-40.15 pg/ mL)...
July 2018: Medicine (Baltimore)
Anmol Gupta Bansal, Rebecca Oudsema, Joy A Masseaux, Henrietta Kotlus Rosenberg
Superficial palpable masses of the head and neck are common in the pediatric population, with the vast majority of the lesions ultimately proven to be benign. Duplex ultrasonography (US) has emerged as the first-line imaging modality for the evaluation of superficial pediatric masses. Without utilizing radiation, iodinated contrast material, or sedation and/or anesthesia, US provides a means for quick and cost-effective acquisition of information, including the location, size, shape, internal content, and vascularity of the mass...
July 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Anne C Kane, Rohan R Walvekar, Jeffrey M Hotaling
Transoral robotic surgery (TORS) has become an increasingly popular option for early malignancies of the oropharynx. It offers superior visualization and has been proven to have acceptable functional and oncologic outcomes. Additionally, indications in head neck have expanded to manage tumors of the thyroid, neck, parapharyngeal space and salivary glands. A 58-year-old female had an incidental finding on CT imaging of a retropharyngeal mass at the level of the hyoid bone. She was referred to a tertiary medical center for further workup and removal of this mass...
July 9, 2018: Journal of Robotic Surgery
Zhe Wei, Bin Sun, Zong-Ping Wang, Jin-Wei He, Wen-Zhen Fu, You-Ben Fan, Zhen-Lin Zhang
Primary hyperparathyroidism is commonly casused by excess production of parathyroid hormone from sporadic parathyroid adenomas. However, the genetic architecture of sporadic primary hyperparathyroidism remains largely uncharacterized, especially in the Chinese population. To identify novel genetic abnormalities that may be involved in the etiology of sporadic parathyroid adenomas and to determine the mutation frequency of previously identified genes in the Chinese population, we performed whole-exome sequencing of 22 blood-tumor pairs from sporadic parathyroid adenomas...
July 3, 2018: Endocrinology
Neal Bhutiani, Beunca Graffree, Robert C G Martin, Amy R Quillo
The aim of this study was to evaluate potential factors affecting the time period in which a 50 per cent parathyroid hormone (PTH) drop is observed. Eight-seven patients undergoing focused parathyroidectomy between 2011 and 2015, whose PTH values dropped to within normal range, were grouped according to whether they required > or ≤15 minutes after gland excision to achieve a 50 per cent PTH. Groups were compared according to preoperative PTH, calcium, age, glomerular filtration rate, and adenoma weight...
June 1, 2018: American Surgeon
Ashwin Singh Parihar, Sanjay Bhadada, Anish Bhattacharya, Bhagwant Rai Mittal
Brown tumors are an uncommon entity associated with hyperparathyroidism. Initially described with primary hyperparathyroidism, with the widespread use of dialysis, they were also seen to be associated with secondary and tertiary hyperparathyroidism. These are lytic, expansile lesions causing bony pains, and depending on the size and extent, skeletal dysmorphism. The present case illustrates the detection of parathyroid adenoma with multiple brown tumors on 99m Tc-sestamibi parathyroid scintigraphy in a patient presenting with facial dysmorphism and multiple bony pains...
July 2018: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
Xuegong Ma, Yingmei Wang, Xuhong Zhang, Mengting Dong, Wen Yang, Fengxia Xue
Hypercalcemia presenting in ovarian cancer is uncommon in the clinic. Here, two cases of ovarian epithelial carcinoma that presented with severe hypercalcemia were reported, with a review of the literature. The laboratory findings and stepwise clinical investigations of these two cases differed, indicating distinct underlying causes of hypercalcemia. In case one, the serum levels and immunostaining for parathyroid hormone-related protein (PTHrP) verified humoral hypercalcemia of malignancy (HHM). In case two, the high level of parathyroid hormone (PTH) and the scintigraphy scan showing parathyroid gland adenoma confirmed primary hyperparathyroidism-induced hypercalcemia...
May 2018: Cancer Biology & Medicine
Aaroh M Parikh, James W Suliburk, Fanny E Morón
OBJECTIVE: ( 1) Review the anatomy and epidemiology of ectopic parathyroid adenomas (EPAs), ( 2) summarize the role of relevant imaging modalities in the localization of EPAs, and ( 3) characterize surgical approaches for various ectopic locations. METHODS: Literature review of published English-language articles from 1995 through August 2017. RESULTS: Summary of the literature indicates that the prevalence of EPA is approximately 20% in unexplored patients with primary hyperparathyroidism, but it is as high as 66% in re-operative patients...
June 2018: Endocrine Practice
Saurabh Arora, Nishikant Avinash Damle, Averilicia Passah, Madhav Prasad Yadav, Sanjana Ballal, Vivek Aggarwal, Yashdeep Gupta, Praveen Kumar, Madhavi Tripathi, Chandrasekhar Bal
Multiple endocrine neoplasia type 1 (MEN1) syndrome is characterized by combined occurrence of tumors of endocrine glands including the parathyroid, the pancreatic islet cells, and the anterior pituitary gland. Parathyroid involvement is the most common manifestation and usually the first clinical involvement in MEN1 syndrome, followed by gastroentero-pancreatic neuroendocrine tumors (NETs). Here we present a case where the patient initially presented with metastatic gastric NET and a single parathyroid adenoma was detected incidentally on 68 Ga-DOTANOC PET/CT done as part of post 177 Lu-DOTATATE therapy (PRRT) follow-up...
June 2018: Nuclear Medicine and Molecular Imaging
X A Yao, T Jiang, B B Wei, H Chang
Objective: To evaluate the clinical characteristics and preoperative predictive factors in patients with parathyroid carcinoma. Methods: From January 2010 to December 2016, 150 patients with pathologically and biochemically confirmed primary hyperparathyroidism were enrolled in this study. The clinical data were reviewed to define 28 cases of parathyroid hyperplasia, 14 cases of parathyroid carcinoma (PC), and 108 cases of parathyroid adenoma (PA). The clinical characteristics between PC and PA group were compared and analyzed to explore predictive factors for PC...
June 23, 2018: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
Mine Araz, Derya Cayir, Bekir Ucan, Alper Dilli, Erman Çakal
OBJECTIVE: (1)To define a quantitative cutoff value for incidental pituitary Technetium-99m methoxyisobutylisonitrile (Tc-99m MIBI) uptake above which is of clinical importance and (2) to investigate possible factors affecting the intensity of uptake in pituitary adenoma. MATERIALS AND METHODS: A retrospective analysis of 55 patients with a simultaneous parathyroid single-photon emission computed tomography and pituitary magnetic resonance imaging were included...
June 20, 2018: Cancer Biotherapy & Radiopharmaceuticals
Deep Dutta, Pradeep Kumar Gupta, Meha Sharma, Nishikant Avinash Damble, Renu Madan, Shruti Dogra
Parathyroid cysts are extremely rare and are rarely associated with primary hyperparathyroidism (PHPT), which are difficult to localise, as they are 99m Tc-sesta-methoxyisobutylisonitrile (sestaMIBI) negative. We report for the first time the utility of 18 F-fluorocholinepositron emission tomography/computerised tomography (PC-PET/CT) in localising parathyroid cyst causing normocalcemic PHPT. A 76-year-old lady with progressively worsening osteoporosis from 2014-2017 (in spite of annual zolendronic acid infusions, daily calcium and vitamin-D supplementation) with persistently normal serum calcium and vitamin D, but elevated parathyroid hormone, had normal sestaMIBI scans of the neck on multiple occasions...
April 2018: European Endocrinology
E Mogas, A Campos-Martorell, M Clemente, L Castaño, A Moreno-Galdó, D Yeste, A Carrascosa
Two pediatric patients with different causes of hyperparathyroidism are reported. First patient is a 13-year-old male with severe hypercalcemia due to left upper parathyroid gland adenoma. After successful surgery, calcium and phosphate levels normalized, but parathormone levels remained elevated. Further studies revealed a second adenoma in the right gland. The second patient is a 13-year-old female with uncommon hypercalcemia symptoms. Presence of pathogenic calcium-sensing receptor gene ( CASR ) mutation was found, resulting in diagnosis of symptomatic familial hypocalciuric hypercalcemia...
2018: Endocrinology, Diabetes & Metabolism Case Reports
Shouyi Yan, Wenxin Zhao, Bo Wang, Liyong Zhang
OBJECTIVE: The study aims to evaluate the clinic feasibility of rapid parathyroid hormone (PTH) detection and nano-carbon technology in preoperative diagnosis and localization of parathyroid adenoma. METHODS: With the guidance of ultrasound, the operator performed the parathyroid puncture and tested the PTH value by using a PTH test kit, and then injected nano-carbon into parathyroid adenoma as a marker to observe whether the parathyroid adenoma was stained black during the final operation...
June 1, 2018: Surgical Innovation
Tagore Sunkara, Megan E Caughey, Prashanth Rawla, Krishna Sowjanya Yarlagadda, Vinaya Gaduputi
Hypercalcemia due to primary or secondary hyperparathyroidism is a rare and obscure cause of acute pancreatitis. Although a rare occurrence to begin with, hyperparathyroidism commonly manifests with symptoms of hypercalcemia. Thus, it would reason that a patient might develop pancreatitis by way of hypercalcemia due to primary or secondary hyperparathyroidism. We present a case of an 88-year-old female with acute pancreatitis and only after an extensive work-up, was it determined that her severe acute pancreatitis resulted from primary hyperparathyroidism caused by a left parathyroid adenoma...
April 7, 2018: Curēus
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