scholarly journals Multiple Brown Tumors in Primary Hyperparathyroidism Caused by an Adenoma Mimicking Metastatic Bone Disease with False Positive Results on Computed Tomography and Tc-99m Sestamibi Imaging: MR Findings

2007 ◽  
Vol 54 (2) ◽  
pp. 205-210 ◽  
Author(s):  
Masashi MIYAKOSHI ◽  
Kyuzi KAMOI ◽  
Toru TAKANO ◽  
Mamiko NISHIHARA ◽  
Tadashi KAWASHIMA ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Primary Hyperparathyroidism ◽  
Bone Disease ◽  
False Positive ◽  
Metastatic Bone Disease ◽  
Sestamibi Imaging ◽  
Brown Tumors ◽  
Positive Results

scholarly journals Severe bone disease caused by primary hyperparathyroidism: a case report and review of the literature

2020 ◽  
Vol 48 (10) ◽  
pp. 030006052096648
Author(s):  
Yu Wang ◽  
Jie Liu
Keyword(s):  
Case Report ◽  
Primary Hyperparathyroidism ◽  
Bone Disease ◽  
Distal Humerus ◽  
Left Lobe ◽  
Pathological Examination ◽  
Hypoechoic Mass ◽  
Brown Tumors ◽  
Restricted Mobility ◽  
The Right

Bone disease is an important complication of hyperparathyroidism. We herein report a rare case of severe bone disease caused by primary hyperparathyroidism. A 33-year-old man presented with pain and restricted mobility in his right upper limb and right hip due to a fall 3 days previously. X-ray examination showed a fracture of the proximal and distal humerus. Computed tomography examination showed a supracondylar fracture of the right humerus, a fracture of the right femoral neck, a fracture of the right sciatic branch, and multiple brown tumors. Ultrasonography showed a 3.5- × 1.6-cm hypoechoic mass below the left lobe of the thyroid. The patient was diagnosed with primary hyperparathyroidism based on increased serum calcium and parathormone concentrations, pathological fractures, and multiple brown tumors. He therefore underwent bilateral lower parathyroidectomy. Pathological examination revealed a parathyroid adenoma. The patient recovered well after surgery and was followed up for 6 months with no symptoms of hyperparathyroidism. This case report suggests that clinicians should be aware of the possibility of severe bone disease secondary to primary hyperparathyroidism. Active and early diagnosis and surgical treatment are important in such cases.

PRE-OPERATIVE LOCALIZATION OF HYPERFUNCTIONING PARATHYROID TISSUE BY PARATHYROID SCINTIGRAPHY

1976 ◽  
Vol 81 (2) ◽  
pp. 298-309 ◽  
Author(s):  
P. Burckhardt ◽  
A. Bischof-Delaloye ◽  
B. Ruedi ◽  
B. Delaloye
Keyword(s):  
Primary Hyperparathyroidism ◽  
False Positive ◽  
Parathyroid Tissue ◽  
Tubular Reabsorption ◽  
Plasma Calcium ◽  
Parathyroid Scintigraphy ◽  
Biochemical Screening ◽  
Parathyroid Adenomas ◽  
Positive Results ◽  
Positive Focus

ABSTRACT In 22 patients who underwent surgery suspected of primary hyperparathyroidism, the surgical findings were compared with the results obtained by pre-operative parathyroid scanning and biochemical screening. Thirteen of 15 parathyroid adenomas were localized by pre-operative scanning, but in five of them a false positive focus was also described. The technique was less useful in primary hyperplasia. Comparable results were reported by other investigators. In both instances the best results were obtained in patients with high parathyroid activity as measured by plasma calcium, plasma alkaline phosphatase and tubular reabsorption of phosphorus (TRP). Parathyroid scintigraphy was especially helpful in the presence of ectopic adenomas and in patients who had undergone previous parathyroid surgery. Unfortunately, the possibility of false positive results makes it unreliable for the diagnosis of primary hyperparathyroidism.

Tc-99m Sestamibi Imaging of Brown Tumors of Primary Hyperparathyroidism

1996 ◽  
Vol 21 (3) ◽  
pp. 192-196 ◽  
Author(s):  
PHILIP A. DINAUER ◽  
ANTONIO G. BALINGIT ◽  
JOSE E. RIVERA
Keyword(s):  
Primary Hyperparathyroidism ◽  
Sestamibi Imaging ◽  
Brown Tumors

An analysis of true- and false-positive results of vocal fold uptake in positron emission tomography-computed tomography imaging

2017 ◽  
Vol 132 (3) ◽  
pp. 270-274 ◽  
Author(s):  
N Seymour ◽  
G Burkill ◽  
M Harries
Keyword(s):  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Head And Neck ◽  
False Positive ◽  
Vocal Fold ◽  
Emission Tomography ◽  
True Positive ◽  
Positron Emission ◽  
Computed Tomography Scans ◽  
Positive Results

AbstractObjectives:Positron emission tomography-computed tomography with fluorine-18 fluorodeoxy-D-glucose has a major role in the investigation of head and neck cancers. Fluorine-18 fluorodeoxy-D-glucose is not a tumour-specific tracer and can also accumulate in benign pathology. Therefore, positron emission tomography-computed tomography scan interpretation difficulties are common in the head and neck, which can produce false-positive results. This study aimed to investigate patients detected as having abnormal vocal fold uptake on fluorine-18 fluorodeoxy-D-glucose positron emission tomography-computed tomography.Methods:Positron emission tomography-computed tomography scans were identified over a 15-month period where reports contained evidence of unilateral vocal fold uptake or vocal fold pathology. Patients’ notes and laryngoscopy results were analysed.Results:Forty-six patients were identified as having abnormal vocal fold uptake on positron emission tomography-computed tomography. Twenty-three patients underwent positron emission tomography-computed tomography and flexible laryngoscopy: 61 per cent of patients had true-positive positron emission tomography-computed tomography scans and 39 per cent had false-positive scan results.Conclusion:Most patients referred to ENT for abnormal findings on positron emission tomography-computed tomography scans had true-positive findings. Asymmetrical fluorine-18 fluorodeoxy-D-glucose uptake should raise suspicion of vocal fold pathology, accepting a false-positive rate of approximately 40 per cent.

Novel Criteria for Parathyroid Hormone Levels in Parathyroid Hormone–Guided Parathyroid Surgery

2007 ◽  
Vol 131 (12) ◽  
pp. 1800-1804
Author(s):  
Robert de Vos tot Nederveen Cappel ◽  
Nicole Bouvy ◽  
Wouter de Herder ◽  
Yolanda de Rijke ◽  
Hans van Toor ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
False Positive ◽  
Parathyroid Surgery ◽  
Cure Rate ◽  
True Negative ◽  
Tertiary Hyperparathyroidism ◽  
Negative Results ◽  
Future Evaluation ◽  
Positive Results

Abstract Context.—Novel criteria for decrease of perioperative parathyroid hormone measurement may improve the accuracy of perioperative quick parathyroid hormone (qPTH)–guided parathyroidectomy. Objective.—To assess overall cure rate based on conventional criteria (50% decline of qPTH). Perioperative qPTH levels were evaluated to determine novel criteria for successful parathyroid surgery. Design.—Analysis of perioperative qPTH measurement findings of all consecutive patients undergoing parathyroidectomy for hyperparathyroidism (72 with primary hyperparathyroidism and 28 with secondary or tertiary hyperparathyroidism or multiple endocrine neoplasia I/IIa disease). Results.—Measurement of qPTH (based solely on the criterion of greater than 50% decline of parathyroid hormone) in 72 patients with primary hyperparathyroidism (77 procedures) showed true-positive results in 69, false-positive results in 4, and true-negative results in 4 procedures. In our series, false-positive and true-negative results were associated with high postexcision levels. However, when qPTH declines of greater than 70% and 80% were used in cases of postexcision qPTH levels of 100 to 200 ng/L and greater than 200 ng/L, respectively, no false-positive results were observed. Conclusions.—Through adherence to these novel criteria, reexploration of the neck could have been prevented in 29% of patients with primary hyperparathyroidism due to multiple gland disease. These novel criteria demand future evaluation to establish their value.

scholarly journals Value of computed tomography for evaluating the subglottis in laryngeal and hypopharyngeal squamous cell carcinoma

2007 ◽  
Vol 125 (2) ◽  
pp. 73-76 ◽  
Author(s):  
Ricardo Pires de Souza ◽  
Nestor de Barros ◽  
Ademar José de Oliveira Paes Junior ◽  
Olger de Souza Tornin ◽  
Abrão Rapoport ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Predictive Value ◽  
False Positive ◽  
False Negative ◽  
Hypopharyngeal Squamous Cell Carcinoma ◽  
Computed Tomography Scans ◽  
Positive Results

CONTEXT AND OBJECTIVE: Subglottic involvement in squamous cell carcinoma is a determining factor for contraindicating conservative partial surgery. The subglottis is easily identified by axial computed tomography sections. The present study aimed to evaluate the occurrence of false-negative and false-positive results, and the overall accuracy of staging by computed tomography, in order to detect the involvement of the subglottic laryngeal compartment, in cases of laryngeal and hypopharyngeal squamous cell carcinoma. DESIGN AND SETTING: Retrospective, non-randomized study of patients treated at Hospital Heliópolis, São Paulo, Brazil. METHODS: Computed tomography scans were performed on third-generation equipment with 5-mm slice thickness. Afterwards, all patients underwent surgical and anatomopathological examinations as the gold standard procedures. RESULTS: Among 60 patients, 14 were diagnosed with subglottic extension by surgical and histopathological examination. There were three false-negative and no false-positive results from computed tomography scans. The sensitivity and negative predictive value were 100.0%. Accuracy was 95.0%, specificity was 93.5% and positive predictive value was 82.4%. CONCLUSIONS: Computed tomography could serve as a powerful auxiliary method for staging laryngeal and hypopharyngeal cancer. However, precautions should be taken in analyzing computed tomography scan data, because vegetating lesions may also be projected into the subglottic compartment, without real involvement of the subglottis, which may cause a false-positive result.

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