Abstract #311: Cystic Parathyroid Adenoma - An Uncommon Cause Of Palpable Neck Mass And Primary Hyperparathyroidism

2006 ◽  
Vol 12 ◽  
pp. 4
Author(s):  
Parul Aneja ◽  
B. Sinnott ◽  
J.M. Loos
Keyword(s):  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Neck Mass

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.

scholarly journals Preoperative localization of suspicious parathyroid adenomas by assay of parathyroid hormone in needle aspirates

1998 ◽  
pp. 72-77 ◽  
Author(s):  
C Marcocci ◽  
S Mazzeo ◽  
G Bruno-Bossio ◽  
A Picone ◽  
E Vignali ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Nodular Goiter ◽  
Neck Mass ◽  
Parathyroid Scintigraphy ◽  
Simple Method ◽  
Cervical Mass ◽  
Parathyroid Adenomas ◽  
Group 2

OBJECTIVE: To determine the usefulness of parathyroid hormone (PTH) measurement in needle aspirates of a suspicious neck mass to confirm its parathyroid nature in patients with primary hyperparathyroidism. METHODS: Thirty-three patients with surgically proved primary hyperparathyroidism were submitted to neck ultrasound (US), parathyroid scintigraphy, and assay of PTH in the aspirate (PTHa) of the suspicious cervical mass. RESULTS: Based on the results of neck US and parathyroid scintigraphy, patients were divided into two groups. Group 1: 16 patients (seven with nodular goiter) with concordant positive US and scintigraphic results. In all but one patient, PTHa was detectable and often markedly elevated (> 1000 pg in 12 patients, between 292 pg and 803 pg in three patients and 53 pg in one patient). The patient with undetectable PTHa had a small lower left parathyroid adenoma (8x8x10 mm). Group 2: 17 patients (12 with nodular goiter) with discordant US and scintigraphic results. PTHa established the parathyroid nature of the mass in 13 cases (> 1000 pg in 8 patients, between 501 pg and 953 pg in three patients and 90 and 79 pg in two patients): 11 of these had a suspected lesion by US examination but the scintigraphy results were negative; two had a mass that gave positive scintigraphy results but was of uncertain origin according to US: in both cases an intrathyroidal parathyroid adenoma was found. PTHa was undetectable in four cases (three with nodular goiter): all of these had equivocal US results, and three had positive scans and one a negative scan. CONCLUSIONS: Assay of PTHa is a simple method and should be useful for confirming the parathyroid nature of a cervical mass in patients with discordant or non-diagnostic US and scintigraphic results.

scholarly journals Parathyroid Adenoma - From Surgical to Biochemical Cure

2021 ◽  
Vol 10 (23) ◽  
pp. 1809-1814
Author(s):  
Rupa Mehta ◽  
Nitin M. Nagarkar ◽  
Satish S.S. ◽  
Ripu Daman Arora ◽  
Jyoti Ranjan Das
Keyword(s):  
Primary Hyperparathyroidism ◽  
Secondary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Parathyroid Gland ◽  
Neck Mass ◽  
The Body ◽  
Parathyroid Glands ◽  
Posterior Aspect ◽  
Biochemical Cure ◽  
High Index Of Suspicion

Parathyroid glands, minute endocrine glands, located in posterior aspect of thyroid glands secrete parathormone which plays an important role in maintaining calcium homeostasis in the body. The superior and inferior parathyroid glands originate from the 4th and 3rd branchial pouches respectively and migrate to occupy their normal positions in relation to the thyroid gland.1 Hyperparathyroidism is defined as hyper functioning of parathyroid gland and can be primary, secondary or tertiary. Primary hyperparathyroidism is due to parathyroid gland proliferative disorders which include parathyroid adenoma, parathyroid hyperplasia, parathyroid carcinoma or in association with other conditions in MEN syndrome. In more than 90 % patients, primary hyperparathyroidism is caused by a single parathyroid adenoma. Very rarely double parathyroid adenomas are seen. Secondary Hyperparathyroidism is caused in response to any chronic hypocalcaemic conditions like renal failure, gastrointestinal malabsorption, dietary rickets & drugs, like phenytoin, phenobarbital & laxative. Prolonged secondary hyperparathyroidism leads to tertiary hyperparathyroidism due to autonomous secretion. The clinical presentation of hyperparathyroidism is classically described as kidney stones, abdominal groans, painful bones, psychic moans, and fatigue overtones. In the initial course of the disease, the patients present with vague symptoms of fatigue, muscle and joint pain, frequent urination, nausea, constipation, and decreased appetite. If high index of suspicion is maintained, they can be conveniently diagnosed by routine blood tests which show increased calcium levels. However, in India still majority of people are diagnosed when they present with palpable neck mass, skeletal manifestations or deranged renal function. We hereby present 5 cases of parathyroid adenoma managed at our centre over a period of 2 years. P

scholarly journals Hyperparathyroidism-Jaw Tumor Syndrome

2021 ◽  
pp. 29-33
Author(s):  
Travis D. Weaver ◽  
Mohamed K.M. Shakir ◽  
Thanh D. Hoang
Keyword(s):  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Serum Calcium ◽  
Age At Onset ◽  
Young Patients ◽  
Neck Mass ◽  
Renal Tumors ◽  
Caucasian Woman ◽  
Her Family ◽  
Focal Uptake

Primary hyperparathyroidism is a relatively common endocrine disorder, affecting 7 out of 1,000 adults. The median age at onset is the 6th decade of life. Our objective was to present a young patient with primary hyperparathyroidism who has a positive CDC73 mutation. A 23-year-old woman was evaluated for hypercalcemia that was found after surgery for bilateral ovarian cyst removal. Her family history included multiple family members with nephrolithiasis. The physical examination revealed a well-appearing Caucasian woman with no palpable neck mass. The laboratory results showed serum calcium at 11.7 mg/dL (ref. 8.4–10.2), ionized calcium at 1.44 mmol/L (ref. 1.12–1.32), and serum PTH at 192 pg/mL (ref. 11–65). A technetium-99 sestamibi scan revealed focal uptake inferior to the left thyroid lobe. Thyroid ultrasound showed a left parathyroid adenoma. The patient subsequently underwent left inferior parathyroidectomy, which confirmed parathyroid adenoma, with resultant normalization of serum calcium and PTH levels. Due to her young age at diagnosis, genetic testing was performed, which revealed a mutation of CDC73. Although penetrance and expression are variable, the CDC73 mutation is associated primarily with hyperparathyroidism-jaw tumor syndrome, familial isolated hyperparathyroidism, and sporadic parathyroid carcinoma. This patient currently has no evidence of jaw, uterine or renal tumors on screening imaging. Given the potential impact of inheritable neoplasia, all young patients with unexplained hyperparathyroidism should be considered for genetic screening.

The volume of parathyroid adenoma is related to presurgical PTH and 25OH-D3, but not calcium levels at patients with primary hyperparathyroidism

2017 ◽  
Author(s):  
Cristian Velicescu ◽  
Cristina Gatu ◽  
Alexandru Grigorovici ◽  
Radu Danila ◽  
Valentin Munteanu ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma

Preoperative matching studies in the diagnosis of parathyroid adenoma for primary hyperparathyroidism: Can we avoid intraoperative PTH monitoring?

2021 ◽  
Author(s):  
Francisco Laxague ◽  
Cristian Agustin Angeramo ◽  
Enrique Dante Armella ◽  
Agustin Cesar Valinoti ◽  
Norberto Aristides Mezzadri ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Intraoperative Pth

scholarly journals Evaluation of diagnostic efficacy for localization of parathyroid adenoma in patients with primary hyperparathyroidism undergoing repeat surgery

2021 ◽  
Author(s):  
Anne Hendricks ◽  
Christina Lenschow ◽  
Matthias Kroiss ◽  
Andreas Buck ◽  
Ralph Kickuth ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Success Rates ◽  
Mri Imaging ◽  
Diagnostic Efficacy ◽  
Repeat Surgery ◽  
Predictive Values ◽  
Increased Risk ◽  
Biochemical Cure ◽  
Diagnostic Modalities

Abstract Purpose Repeat surgery in patients with primary hyperparathyroidism (pHPT) is associated with an increased risk of complications and failure. This stresses the need for optimized strategies to accurately localize a parathyroid adenoma before repeat surgery is performed. However, evidence on the extent of required diagnostics for a structured approach is sparse. Methods A retrospective single-center evaluation of 28 patients with an indication for surgery due to pHPT and previous thyroid or parathyroid surgery was performed. Diagnostic workup, surgical approach, and outcome in terms of complications and successful removement of parathyroid adenoma with biochemical cure were evaluated. Results Neck ultrasound, sestamibi scintigraphy, C11-methionine PET-CT, and selective parathyroid hormone venous sampling, but not MRI imaging, effectively detected the presence of a parathyroid adenoma with high positive predictive values. Biochemical cure was revealed by normalization of calcium and parathormone levels 24–48h after surgery and was achieved in 26/28 patients (92.9%) with an overall low rate of complications. Concordant localization by at least two diagnostic modalities enabled focused surgery with success rates of 100%, whereas inconclusive localization significantly increased the rate of bilateral explorations and significantly reduced the rate of biochemical cure to 80%. Conclusion These findings suggest that two concordant diagnostic modalities are sufficient to accurately localize parathyroid adenoma before repeat surgery for pHPT. In cases of poor localization, extended diagnostic procedures are warranted to enhance surgical success rates. We suggest an algorithm for better orientation when repeat surgery is intended in patients with pHPT.

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