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Objective:To analyze the clinical and pathological features of asymptomatic primary hyperparathyroidism (PHPT) .Methods:A retrospective analysis was carried out in terms of the clinical characteristics and pathological data in 30 patients with asymptomatic PHPT and 86 patients with typical PHPT hospitalized in the Department of Endocrinology and General Surgery of Beijing Jishuitan Hospital from Jan. 2013 to Dec. 2018. There were 7 males (23.3%) and 23 females (76.7%) , with a male to female ratio of 1:3.3. The average age was 56.9±13.3 years. In typical PHPT group, there were 32 males (37.2%) and 54 females (62.8%) , with the average age of 46.4±17.0 years. Bone metabolism indicators included bone density and bone biochemical markers (parathyroid hormone, 25-hydroxyvitamin D and alkaline phosphatase) . The t test was used to compare normally distributed variables, the Mann-Whitney rank sum test was used to compare skewed distributed variables, and the χ 2 test was used to compare enumeration data. Results:The median serum parathyroid hormone and alkaline phosphatase were 144.2 (108.1, 207.0) pg/ml and 80.0 (53.7, 105.5) IU/L respectively, the average serum concentration of calcium was 2.80±0.20 mmol/L, which were significantly lower than those of the classic group ( P<0.05) . The median serum 25-hydroxyvitamin D was 12.14 (7.87, 14.38) ng/ml, which was higher than that of the classic group ( P<0.001) . Ten patients (33.3%) developed osteoporosis, and the incidence was lower than that of the classic group ( P< 0.001) . The median tumor weight was 0.80 (0.25, 1.98) g, significantly smaller than that in the classical group ( P=0.003) . There were 26 cases (86.7%, including 2 atypical parathyroid adenomas) of parathyroid adenomas and 4 cases (13.3%) of hyperplasia. Conclusions:The asymptomatic PHPT has the same sex ratio as the classic type, mainly female, but the average age is significantly higher than that in the classic type. Although asymptomatic PHPT in this study are all benign lesions, abnormal bone biochemical indicators, especially vitamin D deficiency, are common, which also lead to osteoporosis.
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Objective To analyze the CT and magnetic resonance imaging (MRI) manifestations of the pelvic osteosarcoma. Methods The CT and MRI manifestations of 15 cases with pelvic osteosarcoma from January, 2013 to December, 2015 proved by histology were ret-rospectively analyzed. Results There were 10 males and 5 females in them. The median age was 27.0 years. Ilium was involved in 11 cases. A mixed lytic/sclerotic pattern of bone destruction was found in 11 cases, and the sclerotic type in 2 cases, the osteolytic type in 2 cases. Ra-dial periosteal reaction was found in 5 cases and immature bone formation in 8 cases. Soft tissue masses were seen in 13 cases. MRI showed enhancement in 15 cases and the CT showed no enhancement in 2 cases with sclerotic type. Conclusion The typical imaging manifestations of pelvic osteosarcomainclude mixed lytic/sclerotic appearance, radial periosteal reaction, soft tissue masses and immature bone formation.
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Objective To analyze the clinical and imaging features of pulmonary metastasis of giant cell tumor of bone for clinical diagnosis and treatment.Methods Five patients with histologically proven pulmonary metastasis from giant cell tumor of bone were reviewed,the imaging features and the progression of the pulmonary metastasis were evaluated.Results The first operation of primary tumor was curettages and then local recurrence was seen in all 5 cases.The interval to metastasis ranged from 5 to 26 months.Pulmonary metastasis was diagnosed by chest radiographs in 4 cases and CT in all 5 cases.The imaging findings included solitary solid nodule (n =1),multiple solid nodules and mass (n =5),multiple groundglass nodules (n =1) and complex form (n =2).The dynamic follow-up CT findings showed spontaneous regress nodules (n =1),metastasis occurring again 19 months after surgery of solitary nodule (n =1),some solid nodules unchangable for a long time in 3 patients with multiple nodules.Conclusions The dynamic follow-up CT findings of pulmonary metastasis of giant cell tumor of bone are specific.The regular follow-up could play an essential role in early detection and prognosis of pulmonary metastasis within 2 years after primary tumor diagnosed.