ABSTRACT
Objective To analyze clinical features of primary hyperparathyroidism(PHPT)and to evaluate the diagnosis and treatment for PHPT.Methods 115 patients with PHPT undergoing surgery and confirmed by pathology from Jan.2006 to Mar.2014 were retrospectively analyzed.Results The clinical manifestations of PHPT were various.The rate of misdiagnosis was 70.0％(77/115).The positive rate of ultrasonography was 61.0％ (64/105),99Tcm-MIBI 88.3％(68/77)and CT 75.4％(46/61),respectively.The difference among the 3 tested methods had statistical significance (P＜0.05).89 cases with parathyroidoma underwent unilateral neck exploration,6 cases of parathyroid hyperplasia underwent bilateral neck exploration,3 cases with parathyroid carcinoma underwent carcinoma resection,ipsilateral thyroid lobe resection and ipsilateral central lymph node dissection,and 21 cases with thyroid benign or malignant lesions underwent suitable operations.97 cases developed hypocalcaemia of various degrees after operation,and the symptoms were relieved after use of calcium gluconate.Conclusions PHPT can be diagnosed according to the lever of serum calcium and PTH.Ultrasonography and 99Tcm-MIBI should be the first choice for preoperative localization.Unilateral neck exploration can be used for parathyroidoma with accurate localization.
ABSTRACT
Parathyroid carcinoma is a rare disease in patients with primary hyperparathyroidism. We experienced a case of parathyroid carcinoma presenting with hyperparathyroidism. A 62-year-old male patient had hypercalcemia, chronic kidney disease, and an elevated parathyroid hormone level for at least 3 months. An ultrasonogram and parathyroid scan did not show parathyroid neoplasm. He underwent left hemithyroidectomy and parathyroidectomy. Biopsy revealed a parathyroid carcinoma. His azotemia and hypercalcemia improved after surgery.
Subject(s)
Humans , Male , Middle Aged , Azotemia , Biopsy , Hypercalcemia , Hyperparathyroidism , Hyperparathyroidism, Primary , Parathyroid Hormone , Parathyroid Neoplasms , Parathyroidectomy , Rare Diseases , Renal Insufficiency , Renal Insufficiency, ChronicABSTRACT
Bone metastasis is the most common diagnosis considered for lytic lesions in the bone. Parathyroid cancer presenting as overt bone disease with diffuse lytic lesions secondary to untreated hyperparathyroidism (HPT) is a rare entity nowadays. We report the case of a 50-year-old Chinese lady who presented with diffuse bone lesions consistent with Brown tumours, vertebral body collapse and hypercalcaemia mimicking bone metastasis and was later diagnosed with parathyroid cancer.
Subject(s)
Adenocarcinoma , Osteitis Fibrosa Cystica , Hyperparathyroidism , Parathyroid NeoplasmsABSTRACT
No abstract available.
Subject(s)
Aged , Female , Humans , Biomarkers/blood , Biopsy , Calcium/blood , Hyperparathyroidism/blood , Hyperplasia , Parathyroid Glands/metabolism , Parathyroid Hormone/blood , Parathyroid Neoplasms/blood , Parathyroidectomy , Treatment Outcome , Up-RegulationABSTRACT
Parathyroid adenoma usually manifests with symptoms related to hypercalcemia, such as urinary stone and bone fracture. It may also present with asymptomatic hypercalcemia. However, spontaneous cervical hematoma may occur very rarely as a result of extracapsular hemorrhage of a cervical parathyroid adenoma causing acute painful cervical swelling, bruising, dyspnea, hoarseness and dysphagia. We report a 44-year-old woman who manifested as a spontaneous cervical hematoma without any clinical evidence of hyperparathyroidism.
Subject(s)
Adult , Female , Humans , Acute Pain , Deglutition Disorders , Dyspnea , Fractures, Bone , Hematoma , Hemorrhage , Hoarseness , Hypercalcemia , Hyperparathyroidism , Neck , Parathyroid Neoplasms , Urinary CalculiABSTRACT
Parathyroid carcinoma is an uncommon cause of PTH-related hypercalcemia with a reported incidence of 0.4% to 5% of all cases of primary hyperparathyroidism. Even though the clinical manifestations of hyperparathyroidism are more severe in patients with parathyroid carcinoma than in those with parathyroid adenoma, it is difficult to differentiate carcinoma from adenoma preoperatively. Parathyroid carcinomas are usually larger and firmer than parathyroid adenomas and patients with parathyroid carcinoma have a higher incidence of renal dysfunction, bone disease and gastrointestinal symptoms. Anemia is an uncommon clinical feature of parathyroid carcinoma. There have been no prior cases of ectopic parathyroid carcinomas reported to date. In this article, we report the case of a 26-year-old man who developed severe anemia and acute renal failure due to an ectopic parathyroid tumor and was diagnosed with parathyroid carcinoma postoperatively. His serum calcium levels returned to normal and the anemia resolved postoperatively.
Subject(s)
Adult , Humans , Acute Kidney Injury , Adenoma , Anemia , Bone Diseases , Calcium , Hypercalcemia , Hyperparathyroidism , Hyperparathyroidism, Primary , Incidence , Parathyroid Neoplasms , Renal InsufficiencyABSTRACT
Parathyroid carcinoma is a rare entity accounting for only 0.5% to 5% of all cases of parathyroid neoplasm. Most of these malignancies present themselves as functional hormone-producing masses with elevated serum levels of parathormone and calcium. These tumors may also be nonfunctional, which is even rarer. Clinical detection of nonfunctioning parathyroid carcinoma prior to operation is primarily based on symptoms of an expanding neck mass and voice change. These condition may allow it to escape clinical attention until it has achieved an advanced state. So, the prognosis is relatively too bad. Most of these tumors often arise from preexisting parathyroid hyperplasia or adenoma. En bloc resection of primary lesion, ipsilateral thyroid lobe and isthmus together with a neck dissection only in case of lymph node involvement is recommended as the standard treatment. In this paper, we will introduce a case report of a bilateral nonfunctioning parathyroid carcinoma secondary to chronic renal failure.
Subject(s)
Adenoma , Calcium , Hyperplasia , Kidney Failure, Chronic , Lymph Nodes , Neck , Neck Dissection , Parathyroid Hormone , Parathyroid Neoplasms , Prognosis , Thyroid Gland , United Nations , VoiceABSTRACT
Mediastinal parathyroid cyst is a very rare disease and is usually found incidentally. Surgical excision is the treatment of choice and recurrence is very rare when complete excision is done. A 71-year-old man was referred to our department because of 6x5cm sized right superior mediastinal mass found incidentally on chest X-ray. Surgical excision was performed and pathologic findings were confirmed as mediastinal parathyroid cyst. The patient has been followed up postoperatively without recurrence for 4 months up to now. We report a case of mediastinal parathyroid cyst.
Subject(s)
Aged , Humans , Mediastinal Cyst , Parathyroid Glands , Parathyroid Neoplasms , Rare Diseases , Recurrence , ThoraxABSTRACT
BACKGROUND AND OBJECTIVES: Parathyroid gland tumor is a relatively rare disease in Korea. The purpose of our study is to assess the clinical features, diagnostic tools and therapeutic results. MATERIALS AND METHOD: Seven patients with parathyroid gland tumor were analyzed retrospectively. They were diagnosed and received surgical therapy in our hospital from 1995 to 1999. The patients were all female with mean age of 45.3 years (in the range of 21-64 years old). We used ultrasonography, computed tomography, magnetic resonance imaging, parathyroid scan and 18F-FDG positron emission tomograph (PET) to identify the location of parathyroid gland neoplasm. RESULTS: All patients received proper surgical management. Three patients were diagnosed as parathyroid carcinoma, three as parathyroid adenoma and one patient as cavernous hemangioma. Two patients were found as recurrent tumor, Parathyroid carcinoma recurred in one patient, and parathyroid hyperplasia occurred in patient who was previously diagnosed as parathyroid adenoma. CONCLUSION: The results would he a useful guideline for better diagnostic strategies, proper surgical management and follow-up study for recurrence in the parathyroid gland tumor.