Intratracheal parathyroid gland: an unexpected diagnosis

2021 ◽  
Vol 14 (2) ◽  
pp. e239435
Author(s):  
Avery Bryan ◽  
Susan Kurian ◽  
Ashley B Flowers ◽  
Cherie Ann O Nathan
Keyword(s):  
Parathyroid Adenoma ◽  
Parathyroid Gland ◽  
Parathyroid Tissue ◽  
Case Series ◽  
Rare Occurrence ◽  
Laboratory Evidence ◽  
The Masses

Ectopic or supernumerary parathyroid tissue has been generally described in the literature in cases found during workup for parathyroid adenoma. We present two unique cases of intratracheal parathyroid gland, a rare occurrence that has not yet been described in the literature. In both cases, the masses were found incidentally and showed no clinical or laboratory evidence of hyperparathyroidism. In both cases, surveillance was chosen as the method of treatment. We present this case series to increase awareness of this potential diagnosis.

scholarly journals In Search of a Missing Adenoma

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A203-A203
Author(s):  
Tammy Tavdy ◽  
Lakshmi P Mahali
Keyword(s):  
Parathyroid Adenoma ◽  
Parathyroid Gland ◽  
Parathyroid Tissue ◽  
Oral Intake ◽  
Diagnostic Challenge ◽  
Tissue Mass ◽  
Common Cause ◽  
Definitive Therapy ◽  
Increased Sensitivity ◽  
The Right

Abstract Background: The most common cause of primary hyperparathyroidism (PHPT) is overproduction of PTH by a parathyroid gland adenoma. While definitive therapy is parathyroidectomy, 4% of patients develop persistent PHPT - a sustained hypercalcemic state that is detected within six months of parathyroidectomy. A missed parathyroid adenoma is the most common cause of persistent PHPT, and accurately locating these glands presents a diagnostic challenge. We describe a rare case of persistent PHPT due to a missed mediastinal parathyroid adenoma. Case: A 54-year-old woman with a history of PHPT presented with abdominal pain, nausea, and decreased oral intake. She underwent parathyroidectomy six months ago with reimplantation of one parathyroid gland into the right sternocleidomastoid muscle (SCM). She was now hypercalcemic to 13.9 mg/dL (8.5–10.5) with intact PTH 1273 pg/mL (15.0–65.0), vitamin D 25-OH 31.4 ng/mL (>30.0), and normal PTHrP. She was not taking calcium, and other causes of hyperparathyroidism were excluded. Sestamibi scintigraphy localized only to the right SCM, and the initial impression was recurrent HPT due to the previously implanted gland. Follow-up CT neck with and without contrast failed to localize any regrowth in the SCM, but did reveal a 1.4 cm mediastinal soft tissue mass, suspicious for an ectopic parathyroid adenoma. She subsequently underwent video-assisted thoracoscopic excision, and pathology was consistent with ectopic hypercellular parathyroid tissue. Post-operatively, her PTH down-trended and calcium normalized. Conclusion: This case describes a small yet biochemically aggressive mediastinal adenoma causing persistent PHPT. While sestamibi scans have ~90% sensitivity for localization of ectopic adenomas, they can fail to identify a small culprit lesion in 12% of patients, whereas CT imaging with and without contrast has increased sensitivity for adenomas <2 cm. Thus, diagnosing persistent PHPT requires sestamibi scan in combination with other imaging modalities for accurate diagnosis of missed adenomas.

scholarly journals Renal cell carcinoma metastasis to the parathyroid gland: A very rare occurrence

2014 ◽  
Vol 5 (7) ◽  
pp. 378-380 ◽  
Author(s):  
Enyinnaya Ofo ◽  
Rishi Mandavia ◽  
Jean-Pierre Jeannon ◽  
Edward Odell ◽  
Ricard Simo
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Parathyroid Gland ◽  
Renal Cell ◽  
Rare Occurrence ◽  
Renal Cell Carcinoma Metastasis ◽  
Carcinoma Metastasis

scholarly journals PARATHYROID ADENOMA OF THE PIRIFORM SINUS: CASE SERIES, EMBRYOLOGIC BASIS, AND REVIEW OF THE LITERATURE

2017 ◽  
Vol 3 (4) ◽  
pp. e379-e383
Author(s):  
Samuel N. Helman ◽  
Sami P. Moubayed ◽  
Bryan T. Ho ◽  
Corina Din-Lovinescu ◽  
Mark L. Urken
Keyword(s):  
Parathyroid Adenoma ◽  
Case Series ◽  
Review Of The Literature ◽  
Piriform Sinus

scholarly journals Clinicopathological profile of patients with brain secondaries from Ca cervix: a case series of five patients from tertiary cancer centre in North India

2021 ◽  
Vol 10 (8) ◽  
pp. 3208
Author(s):  
Jyoti Sharma ◽  
Mrinalini Upadhyay ◽  
Manish Gupta ◽  
Vikas Fotedar
Keyword(s):  
Radiation Therapy ◽  
Case Series ◽  
Daily Practice ◽  
Best Supportive Care ◽  
North India ◽  
Rare Occurrence ◽  
Cancer Cervix ◽  
Whole Brain Radiation ◽  
Clinicopathological Profile ◽  
Brain Radiation

Ca cervix is a common gynaecological cancer in daily practice but secondaries in brain after ca cervix as primary is a rare occurrence. As the survival of ca cervix patients has improved, we are able to encounter secondaries in unusual sites like brain. Prognosis is usually dismal due to presence of extra cranial mets along with brain secondaries which limits the use of new radiotherapy techniques like Stereotactic radiosurgery. We present a case series of five patients who presented to us post radical treatment of cancer cervix and treated with whole brain radiation therapy and best supportive care.

scholarly journals Primary Hyperparathyroidism due to Parathyroid Adenoma Originated from Supernumerary Gland

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Fernando Mendoza-Moreno ◽  
Ángel Rodriguez-Pascual ◽  
María Rocío Díez-Gago ◽  
Marina Pérez-González ◽  
Laura Jiménez‐Alvárez ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Parathyroid Gland ◽  
Imaging Techniques ◽  
High Sensitivity ◽  
Parathyroid Glands ◽  
Parathyroid Surgery ◽  
Thyroid Lobe ◽  
The Impact ◽  
Supernumerary Gland

Introduction. The variability of the location of the parathyroid glands is directly related to the events that occur during embryonic development. The impact that an individual submits more than four parathyroid glands is close to 13%. However the presentation of a parathyroid adenoma in a supernumerary gland is an uncommon event. Case report. A 30-year-old man diagnosed with primary hyperparathyroidism with matching findings on ultrasonography and scintigraphy for parathyroid adenoma localization lower left regarding the thyroid gland. A cervicotomy explorer showed four orthotopic parathyroid glands. The biopsy of the inferior left gland was normal. No signs of adenoma were seen in the biopsy. Following mobilization of the ipsilateral thyroid lobe, fifth parathyroid gland was found increased significantly in size than proceeded to remove, confirming the diagnosis of adenoma. After the excision, the levels of serum calcium and parathyroid hormone were normalized. Conclusions. The presentation of a parathyroid adenoma in a supernumerary gland is a challenge for the surgeon. The high sensitivity having different imaging techniques has been a key to locate preoperatively the pathological parathyroid gland. Analytical or clinical persistence of primary hyperparathyroidism after parathyroid surgery can occur if the location of the adenoma is a supernumerary or ectopic gland location.

scholarly journals Correction to: Spontaneous neck hematoma secondary to parathyroid adenoma: a case series

2020 ◽  
Vol 277 (9) ◽  
pp. 2559-2559
Author(s):  
Idit Tessler ◽  
Meital Adi ◽  
Judith Diment ◽  
Yonatan Lahav ◽  
Doron Halperin ◽  
...  
Keyword(s):  
Parathyroid Adenoma ◽  
Case Series

ERRATUM

2011 ◽  
Vol 135 (12) ◽  
pp. 1521-1521
Keyword(s):  
Parathyroid Adenoma ◽  
Parathyroid Gland ◽  
Cutaneous Melanoma ◽  
Rare Case ◽  
Tumor Metastasis ◽  
Arch Pathol ◽  
Tumor To Tumor Metastasis ◽  
The Right ◽  
Inferior Parathyroid Gland ◽  
Incorrect Data

An abstract published in the September 2011 issue of the Archives (Murugan P et al. Tumor-to-Tumor Metastasis: A Rare Case of Cutaneous Melanoma Metastatic to a Parathyroid Adenoma [CAP abstract 109, session 100]. Arch Pathol Lab Med. 2011;135[9]:1132) contains incorrect data in line 10 when referring to the right inferior parathyroid gland that was removed. The weight of the gland should have been shown as “…1200-mg (normal, 30–70 mg)…”

scholarly journals Incidental Parathyroid Disease during Thyroid Surgery: Should We Remove Them?

ISRN Surgery ◽  
2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
S. Helme ◽  
A. Lulsegged ◽  
P. Sinha
Keyword(s):  
Primary Hyperparathyroidism ◽  
Parathyroid Gland ◽  
Thyroid Surgery ◽  
Parathyroid Tissue ◽  
Neck Surgery ◽  
Safe Procedure ◽  
Preclinical Phase ◽  
Abnormal Parathyroid Gland ◽  
Parathyroid Disease ◽  
History Of

Aim. Despite an incidence of parathyroid “incidentalomas” of 0.2%–4.5%, only approximately 135 cases have been reported in the literature. We present eight patients in whom an incidental abnormal parathyroid gland was found during routine thyroid surgery. We have reviewed the literature and postulate whether these glands could represent further evidence of a preclinical stage of primary hyperparathyroidism. Methods. A retrospective analysis of all 236 thyroid operations performed by a single surgeon was performed to identify patients in whom abnormal parathyroid tissue was removed at surgery. Results. 8/236 patients (3.39%) had a single macroscopically abnormal parathyroid gland removed and sent for analysis. Seven patients were found to have histological evidence of a parathyroid adenoma or hyperplasia. None of the patients had abnormal serum calcium detected preoperatively. Postoperatively, four patients had normal calcium, three had temporary hypocalcaemia and one refused followup. No patients had recurrent laryngeal nerve impairment. Conclusions. Despite the risk of removing a histologically normal gland, we believe that when parathyroid “incidentalomas” are found during surgery they should be excised and sent for histological analysis. We have found this to be a safe procedure with minimal morbidity to the patient. As the natural history of primary hyperparathyroidism is better understood, these glands found in normocalcaemic patients may in fact represent the early or preclinical phase of the disease. By removing them at the original operation, the patient is saved redo neck surgery with its high complication rate as or when clinically apparent primary hyperparthryoidism develops in the future.

scholarly journals Percutaneous Ultrasound-Guided Laser Ablation with Contrast-Enhanced Ultrasonography for Hyperfunctioning Parathyroid Adenoma: A Preliminary Case Series

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Tianan Jiang ◽  
Fen Chen ◽  
Xiang Zhou ◽  
Ying Hu ◽  
Qiyu Zhao
Keyword(s):  
Laser Ablation ◽  
Parathyroid Adenoma ◽  
Serum Calcium ◽  
Treatment Success ◽  
Case Series ◽  
Contrast Enhanced Ultrasound ◽  
Ultrasound Guided ◽  
Complete Ablation ◽  
Contrast Enhanced ◽  
Serum Pth

The study was to evaluate the safety and effectiveness of ultrasound-guided percutaneous laser ablation (pLA) as a nonsurgical treatment for primary parathyroid adenoma. Surgery was contraindicated in, or refused by, the included patients. No lesion enhancement on contrast-enhanced ultrasound immediately after pLA was considered “complete ablation.” Nodule size, serum calcium, and parathyroid hormone level were compared before and after pLA. Complete ablation was achieved in all 21 patients with 1 (n=20) or 2 (n=1) sessions. Nodule volume decreased from0.93±0.58 mL at baseline to0.53±0.38and0.48±0.34 mL at 6 and 12 months after pLA (P<0.05). At 1 day, 6 months, and 12 months after pLA, serum PTH decreased from15.23±3.00 pmol/L at baseline to7.41±2.79,6.95±1.78, and6.90±1.46 pmol/L, serum calcium decreased from3.77±0.77 mmol/L at baseline to2.50±0.72,2.41±0.37, and2.28±0.26 mmol/L, respectively (P<0.05). At 12 months, treatment success (normalization of PTH and serum calcium) was achieved in 81%. No serious complications were observed. Ultrasound-guided pLA with contrast-enhanced ultrasound is a viable alternative to surgery for primary parathyroid adenoma.

Sign in / Sign up

Export Citation Format

Share Document