scholarly journals A rare case of a parathyroid adenoma inside a parathyroid cyst

2014 ◽  
Vol 58 (7) ◽  
pp. 776-778 ◽  
Author(s):  
Spyridon N. Karras ◽  
Ioannis Koutelidakis ◽  
Panagiotis Anagnostis ◽  
Gesthimani Mintziori ◽  
Nikolaos Pontikides ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Therapeutic Approach ◽  
Rare Case ◽  
Cervical Lesions ◽  
Parathyroid Cyst ◽  
Parathyroid Cysts

Parathyroid cysts (PCs) are rare lesions, located in the neck and anterior mediastinal region. The vast majority are non-functioning, presented as nodular cervical lesions. Large, non-functioning PCs can manifest with compressive symptoms of the surrounding tissues. Rarely, PCs produce excessive amounts of parathyroid hormone (PTH), resulting in primary hyperparathyroidism. We report a case of functional PC, describing its diagnostic and therapeutic approach.

Incidentally discovered severe hypercalcaemia from a functioning parathyroid cyst: the limitations of intraoperative parathyroid hormone (IOPTH) monitoring

2021 ◽  
Vol 14 (5) ◽  
pp. e239119
Author(s):  
Juan Carlos Nogues ◽  
Robert Cox ◽  
Collin Mulcahy ◽  
Daniel Benito ◽  
Joseph Goodman
Keyword(s):  
Parathyroid Hormone ◽  
Parathyroid Adenoma ◽  
Surgical Resection ◽  
Unique Case ◽  
Parathyroid Cyst ◽  
Intraoperative Pth ◽  
Parathyroid Cysts ◽  
Severe Hypercalcaemia ◽  
Intraoperative Parathyroid Hormone

Parathyroid cysts (PCs) are rare pathologies and are typically non-functional (do not secrete parathyroid hormone (PTH)). The aetiology of PCs is highly debated, and management is complex. We present a unique case of a parathyroid adenoma contained within a functional PC and highlight the limitations of intraoperative PTH monitoring during the surgical resection of functional PCs.

scholarly journals Giant parathyroid adenoma: a case report and review of the literature

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Mohamed S. Al-Hassan ◽  
Menatalla Mekhaimar ◽  
Walid El Ansari ◽  
Adham Darweesh ◽  
Abdelrahman Abdelaal
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Neck Mass ◽  
Rare Type ◽  
Tissue Mass ◽  
Laboratory Findings ◽  
Clinical Presentations ◽  
High Calcium

Abstract Background Giant parathyroid adenoma is a rare type of parathyroid adenoma defined as weighing > 3.5 g. They present as primary hyperparathyroidism but with more elevated laboratory findings and more severe clinical presentations due to the larger tissue mass. This is the first reported case of giant parathyroid adenoma from the Middle East. Case presentation A 52-year-old Indian woman presented with a palpable right-sided neck mass and generalized fatigue. Investigations revealed hypercalcemia with elevated parathyroid hormone and an asymptomatic kidney stone. Ultrasound showed a complex nodule with solid and cystic components, and Sestamibi nuclear scan confirmed a giant parathyroid adenoma. Focused surgical neck exploration was done and a giant parathyroid adenoma weighing 7.7 gm was excised. Conclusions Giant parathyroid adenoma is a rare cause of primary hyperparathyroidism and usually presents symptomatically with high calcium and parathyroid hormone levels. Giant parathyroid adenoma is diagnosed by imaging and laboratory studies. Management is typically surgical, aiming at complete resection. Patients usually recover with no long-term complications or recurrence.

Ossifying fibroma of the mandible with primary hyperparathyroidism due to non-familial parathyroid adenoma

2006 ◽  
Vol 121 (3) ◽  
pp. 281-284 ◽  
Author(s):  
A Harimaya ◽  
H Tsubota ◽  
K Hoki ◽  
J Sato ◽  
A Kondo ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Periodontal Ligament ◽  
Rare Case ◽  
Complete Resection ◽  
Ossifying Fibroma ◽  
Titanium Plate ◽  
Parathyroid Dysfunction ◽  
Parathyroid Tumours ◽  
Progressive Enlargement

Ossifying fibroma is an uncommon benign osteogenic neoplasm arising from cells of the periodontal ligament, typically with a slowly progressive enlargement of the affected bone. The neoplasm sometimes presents with hyperparathyroidism, most of which cases are due to familial parathyroid tumours. We report a rare case of ossifying fibroma of the mandible which showed very rapid growth and presented with primary hyperparathyroidism due to non-familial parathyroid adenoma. Despite improvement of parathyroid dysfunction after removal of the parathyroid adenoma, the tumour continued to grow very aggressively. The case required partial mandibular resection for complete resection of the tumour, and fixation of the remaining mandible with a titanium plate.

scholarly journals Primary Hyperparathyroidism: Modern Conception and Clinical Observation

2020 ◽  
Vol 10 (2) ◽  
pp. 94-101
Author(s):  
L. M. Farkhutdinova
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Clinical Manifestations ◽  
Premature Death ◽  
Developed Countries ◽  
Severe Form ◽  
Mineral Density ◽  
Target Organs ◽  
Increased Risk

The article is devoted to one of the actual medical and social problems — primary hyperparathyroidism, the late diagnosis of which leads to the development of severe complications and an increased risk of premature death. Unlike developed countries, where 80% of cases are represented by mild forms of the disease, in the Russian Federation this indicator does not exceed 30%, while 70% are manifest forms. Widespread awareness of doctors of various specialties in the diagnosis of parathyroid adenoma is necessary for the timely detection of the disease. The article reflects the main stages of the study of the disease, the pathogenesis of the clinical manifestations of primary hyperparathyroidism, the classic symptoms of which are changes in the target organs of the parathyroid hormone — bone tissue, urinary system and gastrointestinal tract, is considered. Bone disorders are the most common manifestation of hyperparathyroidism and are characterized by increased bone metabolism with a progressive decrease in bone mineral density. Typical changes in the kidneys include nephrolithiasis and nephrocalcinosis, causing the formation of renal failure. Gastrointestinal signs of hyperparathyroidism are erosion and ulcers of the stomach and duodenum, prone to bleeding, recurrent pancreatitis. Diagnosis of the disease is based on laboratory results, characterized by elevated levels of calcium and parathyroid hormone in the blood. Visualization of the paradenomas in most cases is provided by ultrasound and scintigraphy. Removal of parathyroid adenoma is the most effective treatment. A clinical case of a severe form of the disease is presented, indicating an urgent need to take measures to solve the problem of primary hyperparathyroidism.

scholarly journals MON-LB66 Altered Mental Status and Hypercalcemia: A Rare Presentation of Pure Osteolytic Metastatic Prostate Cancer

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Ajinkya Kulkarni ◽  
Mrunal Kulkarni ◽  
Rithikaa Ellangovan ◽  
Rajesh Thirumaran
Keyword(s):  
Prostate Cancer ◽  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Mental Status ◽  
Serum Calcium ◽  
Bone Scan ◽  
Rare Case ◽  
Osteolytic Metastasis ◽  
Prostate Cancers ◽  
Osteoblastic Lesions

Abstract Background: We present a rare case of hypercalcemia with the concomitant presence of parathyroid adenoma, secondary hyperparathyroidism due to kidney disease and hypercalcemia of malignancy. Mild hypercalcemia due to primary hyperparathyroidism often precedes the acute, more severe hypercalcemia of malignancy. Prostate cancers are usually known to cause osteoblastic lesions. We present a rare case of prostate cancer with pure osteolytic metastasis. Case: 73 year old male with past history of ESRD on hemodialysis was brought to the ER with change in mental status. Labs showed elevated serum calcium 13.3 mg/dl (8.6-10.2 mg/dl) and creatinine 7.0 mg/dl (0.60-1.30mg/dl). Patient underwent emergent hemodialysis. Additional lab work revealed, elevated phosphorus level of 5.8mg/dl (2.5-5 mg/dl), low vitamin D 25-hydroxy of 22 ng/ml (30-100 ng/ml) and vitamin 1-25 dihydroxy level of 7 ng/ml (20-79 ng/ml). Both PTH 172.6 pg/ml (12-88 pg/ml) and PTHrP 64 pg/ml (14-27 pg/dl) levels were elevated. Parathyroid scan showed increased uptake in left inferior parathyroid gland indicating the presence of a parathyroid adenoma. Serum calcium levels remained persistently elevated despite being continued on dialysis with a low calcium bath and receiving calcium lowering therapy with calcium binding agent- cinacalcet, calcitonin, bisphosphonate. Further work up for refractory hypercalcemia revealed an elevated prostate-specific antigen (PSA) level of 1420 ng/ml (0-3.999 ng/ml). Bone scan showed no evidence of osseous metastasis. CT abdomen & pelvis showed extensive lytic bony metastases, with metastasis to lung and lymph nodes in mesenteric root and in the pelvis. Prostate gland showed asymmetric contour along the left posterolateral zone suspicious for malignancy with extracapsular spread.Biopsy from the left iliac lytic bone lesion was done that showed poorly differentiated metastatic adenocarcinoma, consistent with a prostatic primary. The patient was started on treatment with anti-androgen medication- Bicalutamide and prednisone and was planned to be started on Leuprolide as outpatient. Discussion: Hypercalcemia is uncommon in advanced prostate cancer compared to other malignancies where osteolytic metastasis is more common than osteoblastic metastasis. Incidence of malignancy in patients with primary hyperparathyroidism and vice-versa is high, hence serum PTH and PTHrP should be measured in hypercalcemic patients with malignancy. If PTHrP and PTH are both elevated, it indicates co-existent primary hyperparathyroidism. Prostate cancers are usually known to cause osteoblastic lesions and pure osteolytic metastasis from prostate carcinoma is extremely rare. Radio-nucleotide bone scan preferentially detects osteoblastic metastasis. CT or MRI is indicated to look for osteolytic lesions if suspicion for bone metastasis is high.

Konversion eines postoperativen Hypoparathyreoidismus in einen Hyperparathyreoidismus bei ektopem Nebenschilddrüsenadenom

2019 ◽  
Vol 58 (04) ◽  
pp. 333-336
Author(s):  
K. H. Davis ◽  
C. Happel ◽  
R. du Mesnil de Rochemont ◽  
T. J. Vogl ◽  
F. Grünwald
Keyword(s):  
Thyroid Cancer ◽  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Imaging Modalities ◽  
Hormone Levels ◽  
History Of ◽  
Childhood Medulloblastoma ◽  
Vein Catheterization

AbstractWe present a patient with a history of thyroid cancer, presumably following radiochemotherapy of a childhood medulloblastoma, who developed a primary hyperparathyroidism 10 years after long-term postsurgical hypoparathyroidism. All established imaging modalities failed to detect the origin and only selective neck sampling could identify the suspected parathyroid adenoma causing hyperparathyroidism. This encourages the use of selective neck vein catheterization, particularly in patients with only slightly elevated parathyroid hormone-levels or suspected small ectopic adenoma.

scholarly journals A Case of Primary Hyperparathyroidism due to Intrathyroidal Parathyroid Cyst

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Yavuz Yalcin ◽  
Turkan Mete ◽  
Recep Aktimur ◽  
Gultekin Ozan Kucuk ◽  
Gulhan Duman ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Cystic Degeneration ◽  
Ipth Level ◽  
Parathyroid Cyst ◽  
Parathyroid Adenomas ◽  
Parathyroid Lesions ◽  
Cyst Aspiration ◽  
Left Lobectomy ◽  
Parathyroid Cysts ◽  
Left Thyroid Lobe

Parathyroid cysts constitute 0.08–3.41% of all parathyroid masses. Intrathyroidal parathyroid cysts, however, are rare conditions with only a few cases being reported. Most of the parathyroid cysts are found to be nonfunctional and functional cysts are generally thought to be due to cystic degeneration of parathyroid adenomas. A cystic, smooth contoured lesion of 24 × 19 × 16 mm was observed in left thyroid lobe of a 76-year-old woman during ultrasonography which was performed as routine workup for primary hyperparathyroidism. It was defined as a cystic thyroid nodule at first. Tc99msestamibi scintigraphy was performed to see any parathyroid lesions, but no radioactive uptake was observed. Intact parathormone (iPTH) level was found to be >600 pg/mL in cyst aspiration fluid. Left lobectomy was performed, with a diagnosis of primary hyperparathyroidism due to functional parathyroid cyst. Serum iPTH level was decreased >50% postoperatively and histopathological evaluation was consistent with an encapsulated parathyroid adenoma with a cystic center. Parathyroid cysts are among rare causes of primary hyperparathyroidism. Diagnosis is made by markedly increased iPTH level in cyst fluid and observation of parathyroid epithelium lining the cyst wall.

Coexistence of a parathyroid adenoma and parathyroid cyst causing primary hyperparathyroidism

2003 ◽  
Vol 26 (7) ◽  
pp. 679-682 ◽  
Author(s):  
G. Ardito ◽  
G. Fadda ◽  
D. Danese ◽  
Pietro Modugno ◽  
A. Giordano ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Parathyroid Cyst

scholarly journals Giant Parathyroid Adenoma

2012 ◽  
Vol 9 (1) ◽  
pp. 77-79
Author(s):  
M Jayant ◽  
R Kaushik ◽  
S Kochar ◽  
A K Attri
Keyword(s):  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Rare Case ◽  
Large Size ◽  
Biochemical Abnormalities

Primary Hyperparathyroidism is most commonly caused by parathyroid adenoma. Parathyroid adenoma is generally suspected by certain symptoms and biochemical abnormalities. They rarely attain large size to be evident clinically. We report a rare case of giant parathyroid adenoma measuring 5x4x3cm and weighing 35 gm.http://dx.doi.org/10.3126/kumj.v9i1.6269 Kathmandu Univ Med J 2011;9(1):77-9 

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