Neonatal, severe primary hyperparathyroidism: a 7-year clinical and radiological follow-up of one patient

2002 ◽  
Vol 32 (9) ◽  
pp. 684-689 ◽  
Author(s):  
Andrea S. Doria ◽  
Carol Huang ◽  
Outi Makitie ◽  
Paul Thorner ◽  
Sang W. Kooh ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Neonatal Severe Primary Hyperparathyroidism

scholarly journals Cured primary hyperparathyroidism after fine-needle aspiration biopsy-induced parathyroid disappearance

2017 ◽  
Vol 2017 ◽  
Author(s):  
Elda Kara ◽  
Elisa Della Valle ◽  
Sara De Vincentis ◽  
Vincenzo Rochira ◽  
Bruno Madeo
Keyword(s):  
Primary Hyperparathyroidism ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Complete Disappearance ◽  
List Type ◽  
Fine Needle ◽  
Time Period ◽  
History Of

Summary Spontaneous or fine-needle aspiration (FNAB)-induced remission of primary hyperparathyroidism (PHPT) may occur, especially for cystic lesions. However, the disease generally relapses over a short time period. We present a case of PHPT due to an enlarged hyperfunctioning parathyroid that underwent long-term (almost 9 years) clinical and ultrasonographic remission after the disappearance of the lesion following ultrasound (US)-assisted FNAB. A 67-year-old woman with PHPT underwent biochemical and US examinations that confirmed the diagnosis and showed a lesion suggestive for parathyroid adenoma or hyperplasia. US-FNAB of the lesion confirmed its parathyroid nature by means of elevated levels of parathyroid hormone within the needle washing fluid. At the second visit, the patient referred slight neck swelling that resolved spontaneously in the days after the US-FNAB. At subsequent follow-up, the enlarged parathyroid was not found; it was visible neither with US nor with magnetic resonance imaging. Biochemical remission persists after 9 years. This is the first reported case of cure of PHPT after US-FNAB performed on a hyperfunctioning parathyroid resulting in its complete disappearance over a period of 9 years of negative biochemical and ultrasonographic follow-up. Learning points: Spontaneous or fine-needle aspiration-induced remission of primary hyperparathyroidism can occur. Both circumstances may present disease relapse over a variable time period, but definite remission is also possible even though long-term periodic follow-up should be performed. Parathyroid damage should be ruled out in case of neck symptomatology after parathyroid fine-needle aspiration or spontaneous symptomatology in patients with history of primary hyperparathyroidism.

scholarly journals Parathyroid carcinoma

2006 ◽  
Vol 63 (8) ◽  
pp. 765-769
Author(s):  
Aleksandar Filipovic ◽  
Ivan Paunovic ◽  
Dragutin Savjak ◽  
Tamara Zivkovic
Keyword(s):  
Primary Hyperparathyroidism ◽  
Parathyroid Carcinoma ◽  
Disease Recurrence ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Endocrine Tumors ◽  
En Bloc ◽  
Histologic Diagnosis ◽  
Serum Pth

Background. Parathyroid carcinoma is the least frequent malignancy among endocrine tumors. In the most reported series of patients with primary hyperparathyroidism the incidence of carcinoma is less than 1%. Recognition by a surgeon that the parathyroid tumor is malignant, and the performance of an adequate en bloc removal of primary lesion, with histologic diagnosis offer the best treatment of a patient with this unusual malignancy. Case report. We reported a 30-year-old patient with parathyroid carcinoma, primary hyperparathyroidism, and recurrent nephrocalcinosis. Marked hypercalcemia, low serum phosphorus, and substantial elevation of serum parathyroid hormone indicated a diagnosis of primary hiperparathyroidism. General symptoms were anorexia, muscle weakness, back pain and depression. Ultrasonography done before the surgery revealed a 2 cm upper left parathyroid gland with solid and cystic areas. The neck exploration was done with en block resection of the tumor. A histopathological evaluation confirmed the diagnosis of parathyroid carcinoma. Over more than a three-year-follow-up, the patient had no evidence of the disease recurrence and his serum PTH and calcium levels remained within the normal. Conclusion. Parathyroid carcinoma is a rare cause of primary hyperparathyroidism. Preoperative diagnosis remains a challenge. Radical en bloc resection of the tumor is the treatment of choice for this malignancy.

Single Centre Experience in Patients with Primary Hyperparathyroidism: Sporadic, Lithium-associated and in Multiple Endocrine Neoplasia

2019 ◽  
Vol 128 (10) ◽  
pp. 693-698
Author(s):  
Sabine Dillenberger ◽  
Detlef K. Bartsch ◽  
Elisabeth Maurer ◽  
Peter Herbert Kann
Keyword(s):  
Primary Hyperparathyroidism ◽  
Multiple Endocrine Neoplasia ◽  
University Hospital ◽  
Primary Surgery ◽  
Endocrine Neoplasia ◽  
Single Centre Experience ◽  
Significant Difference ◽  
History Of ◽  
The University

Abstract Purpose It is assumed that primary hyperparathyroidism (pHPT) in Multiple Endocrine Neoplasia (MEN) and lithium-associated pHPT (LIHPT) are associated with multiple gland disease (MGD), persistence and recurrence. The studies purpose was to determine frequencies, clinical presentation and outcome of sporadic pHPT (spHPT), LIHPT and pHPT in MEN. Additional main outcome measures were the rates of MGD and persistence/recurrence. Methods Retrospective analysis of medical records of 682 patients with pHPT who had attended the University Hospital of Marburg between 01–01–2004 and 30–06–2013. All patients were sent a questionnaire asking about their history of lithium medication. Results Out of 682 patients, 557 underwent primary surgery (532 spHPT, 5 LIHPT, 20 MEN), 38 redo-surgery (31 spHPT, 7 MEN), 55 were in follow-up due to previous surgery (16 spHPT, 1 LIHPT, 38 MEN) and 37 were not operated (33 spHPT, 1 LIHPT, 3 MEN). Primary surgeries were successful in 97.4%, revealed singular adenomas in 92.4%, double adenomas in 2.9% and MGD in 3.4% of the cases. Rates of MGD in MEN1 (82.35%) were significantly higher than in spHPT (3.8%), while there was no significant difference between LIHPT (20%) and spHPT. Rates of persistence/recurrence did not significantly differ due to type of surgery (bilateral/unilateral) or type of HPT (spHPT/LIHPT/MEN). Conclusions History of lithium medication is rare among pHPT patients. While MGD is common in MEN1, rates of MGD, persistence or recurrence in LIHPT were not significantly higher than in spHPT.

Surgical Therapy for Familial Hyperparathyroidism

2009 ◽  
Vol 75 (7) ◽  
pp. 579-583 ◽  
Author(s):  
Jyotirmay Sharma ◽  
Collin J. Weber
Keyword(s):  
Primary Hyperparathyroidism ◽  
Cure Rate ◽  
Patient Demographics ◽  
Initial Surgery ◽  
Sestamibi Scanning ◽  
Recurrence Patterns ◽  
Sporadic Primary Hyperparathyroidism ◽  
Intraoperative Parathyroid Hormone ◽  
Familial Hyperparathyroidism

Isolated familial hyperparathyroidism (FHPT) not associated with multiple endocrine neoplasia is a rare and aggressive form of primary hyperparathyroidism. The traditional management of FHPT is a bilateral neck exploration with an increased rate of multigland hyperplasia, supernumerary glands, and recurrence. A prospective database was queried, which included 1383 consecutive parathyroidectomies between 1992 and 2008, and 28 patients with FHPT were identified. Patient demographics, pathology, intraoperative parathyroid hormone (IOPTH) kinetics, recurrence patterns, and accuracy of localization studies were analyzed. Twenty-one patients underwent bilateral neck explorations as an initial surgery, and seven patients had nine unilateral neck explorations for recurrent hyperparathyroidism. Overall cure rate was 89.2 per cent with a mean follow-up of 2.9 years (range: 6 months to 9.2 years); 64.3 per cent of patients had multigland disease. IOPTH helped identify supernumerary glands in three (12.5%) patients and accurately lateralized recurrent disease in eight of nine surgeries (88.8%). Tc-99m-Sestamibi failed to identify multigland disease in 11 patients (52.3%). FHPT has a greater prevalence of multigland disease, decreased utility of sestamibi scanning, and a higher recurrence rate than sporadic primary hyperparathyroidism. In FHPT, IOPTH is a useful adjunct in identifying additional tumors and in select cases may play a role in tumor localization.

scholarly journals Frequency of various types of neoplasia in a group of acromegalic patients

2013 ◽  
Vol 57 (8) ◽  
pp. 612-616
Author(s):  
Fernanda Bolfi ◽  
Helio Amante Miot ◽  
Mariangela Resende ◽  
Glaucia M. S. F. Mazeto ◽  
Fernando Gomes Romeiro ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Basal Cell Carcinoma ◽  
Primary Hyperparathyroidism ◽  
High Frequency ◽  
Acanthosis Nigricans ◽  
Thyroid Nodules ◽  
Colon Adenocarcinoma ◽  
Thyroid Tumor ◽  
Thyroid Tumors

OBJECTIVE: To determine the frequency of colon cancer, primary hyperparathyroidism, thyroid tumor, and skin cancer in all acromegalic patients in follow-up at the Clinics Hospital - Botucatu Medical School, from 2005 to 2011. SUBJECTS AND METHODS: These patients were evaluated retrospectively for colon cancer, primary hyperparathyroidism, dermatological, and thyroid tumors. RESULTS: Of 29 patients included at the beginning of the study, two were excluded. Among 19 patients submitted to colonoscopy, one presented colon adenocarcinoma (5%). Thyroid nodules were present in 63% of patients, and papilliferous carcinoma was confirmed in two patients (7,7%). Four patients were confirmed as having primary hyperparathyroidism (15%). The most common dermatologic lesions were thickened skin (100%), acrochordons (64%), epidermal cysts (50%), and pseudo-acanthosis nigricans (50%). Only one patient presented basal cell carcinoma. CONCLUSION: Although a small number of acromegalic patients was studied, our findings confirm the high frequency of thyroid neoplasias and primary hyperparathyroidism in this group of patients.

Forearm bone density in primary hyperparathyroidism: long-term follow-up with and without parathyroidectomy

2003 ◽  
Vol 58 (3) ◽  
pp. 348-354 ◽  
Author(s):  
D. Sudhaker Rao ◽  
Elizabeth A. Wallace ◽  
Rosella F. Antonelli ◽  
Gary B. Talpos ◽  
Mohammed R. Ansari ◽  
...  
Keyword(s):  
Bone Density ◽  
Primary Hyperparathyroidism ◽  
Long Term Follow Up ◽  
Forearm Bone

scholarly journals Persistent disease after surgery for primary hyperparathyroidism: the long-term outcome

2004 ◽  
pp. 19-25 ◽  
Author(s):  
G Hedback ◽  
A Oden
Keyword(s):  
Primary Hyperparathyroidism ◽  
Serum Calcium ◽  
Bone Fractures ◽  
State Of Health ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Persistent Disease ◽  
Long Time ◽  
Extensive Surgery

OBJECTIVE: Nineteen patients with persistent primary hyperparathyroidism were investigated to evaluate their clinical and laboratory status a long time after treatment was ended. The risk of persistent disease and need for extensive surgery for cure, i.e. more than two neck operations, or mediastinal exploration, was also evaluated. DESIGN: The medical records of 896 consecutive patients operated on for primary hyperparathyroidism were scrutinised at follow-up, a mean of 10.3 Years after surgery. Data on state of health, medication, bone fractures and other diagnoses were collected by use of a questionnaire. There were 600 patients still alive, among whom 13 had persistent disease and they were compared with 509 patients who were cured and without any suspicion of recurrent disease, according to laboratory examination. RESULTS: Serum calcium and creatinine values had with few exceptions remained stable over the Years. In five patients, serum calcium levels were within the normal range at follow-up. Still, all 19 patients were considered hyperparathyroid. They had substantial cardiovascular morbidity, and their state of health was not as good as that of the patients who were surgically cured. After one operation, 5.5% (95% confidence interval (CI) 4.0-7.2%) had persistent disease, and 2.1% after reoperation. Extensive surgery for cure was performed in 2% of the patients (95% CI 1.1-3.2%). CONCLUSIONS: We found that the state of health was significantly better for patients with cured primary hyperparathyroidism than for patients with persistent disease, but serious deterioration of laboratory values was uncommon. The result of the present study supports surgical treatment.

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