Preeclampsia: A Possible Complication of Primary Hyperparathyroidism

Background. Primary hyperparathyroidism is rare in pregnancy. An association between primary hyperparathyroidism and preeclampsia has been reported in few cases worldwide.Case. A 28-year-old woman (gravida 2, para 0, and abortus 1) in her 27th week of gestation was hospitalized due to a high reading of blood pressure (194/115 mmHg) that was not accompanied by any symptoms or signs of preeclampsia. Incidentally, she was found to have a high adjusted calcium and serum parathyroid hormone (PTH) level during admission. Ultrasonographic examination of the neck revealed the presence of parathyroid adenoma. She was scheduled for surgical excision after receiving an intravenous hydration. Fetal ultrasonography revealed a growth restricted fetus with normal biophysical profile. On the sixth day of hospitalization, the patient complained of headache and epigastric pain, with elevated BP and proteinuria. The fetal nonstress test was “nonreassuring.” Subsequently, she had an emergency cesarean delivery and surgical removal of the adenoma. The mother and her newborn were then transferred to intensive care, where their clinical course was unremarkable. The mother was discharged after 3 days, while the neonate stayed for close observation for 60 days.Conclusion. Early recognition of primary hyperparathyroidism among women with preeclampsia is important to prevent maternal and fetal morbidity and mortality.

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Excision of Lower Lip Mucocele Using Injection of Hydrocolloid Dental Impression Material in a Pediatric Patient: A Case Report

Applied Sciences ◽

10.3390/app11135819 ◽

2021 ◽

Vol 11 (13) ◽

pp. 5819

Author(s):

Gianluca Botticelli ◽

Marco Severino ◽

Gianmaria Fabrizio Ferrazzano ◽

Pedro Vittorini Velasquez ◽

Carlo Franceschini ◽

...

Keyword(s):

Minor Salivary Gland ◽

Surgical Techniques ◽

Surgical Excision ◽

Complete Healing ◽

Surgical Removal ◽

Clinical Approach ◽

Lower Lip ◽

Impression Material ◽

Dental Impression

Oral mucocele is a benign cystic exophytic lesion affecting the minor salivary gland and is especially present in pediatric patients (3% under 14 years). It is characterized by an extravasation or retention of fluid or mucus in the submucosal tissue of the minor salivary glands. Several surgical techniques have been proposed over the years, including the excision of the mucocele by using the injection of a hydrocolloid impression material in the light of the cyst to prevent the collapse of the cystic wall and solidify the lesion, resulting in a better cleavage plan. The combined clinical approach between the combination of Shira’s technique and the surgical excision of the cystic lesion results in a conservative surgical removal of the lesion. Here, we reported the removal of a labial mucocele in a 14-year-old male patient, using the injection of a hydrocolloid impression material. At a 12 months follow up, the patient showed complete healing of the surgical site, showing a pinkish lip lining mucosa without scarring or recurrence of the primary lesion. The combined therapeutic approach between Shira’s technique and surgical excision allows a safe and predictable excision of the labial mucocele, minimizing the risk of recurrence.

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Bone and Mineral Metabolism Phenotypes in MEN1-Related and Sporadic Primary Hyperparathyroidism, before and after Parathyroidectomy

Cells ◽

10.3390/cells10081895 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1895

Author(s):

Francesca Marini ◽

Francesca Giusti ◽

Federica Cioppi ◽

Davide Maraghelli ◽

Tiziana Cavalli ◽

...

Keyword(s):

Primary Hyperparathyroidism ◽

Bone Mass ◽

Bone Metabolism ◽

Mineral Metabolism ◽

Parathyroid Tissue ◽

Young Patients ◽

Surgical Removal ◽

Mineral Density ◽

Bone Mass Loss ◽

Before And After

Primary hyperparathyroidism (PHPT) is the most common endocrinopathy in multiple endocrine neoplasia type 1 (MEN1). Persistent levels of increased parathyroid hormone (PTH) result in a higher incidence of osteopenia and osteoporosis compared to the general population. Surgical removal of hyper-functioning parathyroid tissue is the therapy of choice. This retrospective study evaluated the effect of parathyroidectomy (PTX) on bone metabolism and bone mass in two series of patients with MEN1 PHPT and sporadic PHPT (sPHPT) by comparing bone metabolism-related biochemical markers and bone mineral density (BMD) before and after surgery. Our data confirmed, in a higher number of cases than in previously published studies, the efficacy of PTX, not only to rapidly restore normal levels of PTH and calcium, but also to normalize biochemical parameters of bone resorption and bone formation, and to improve spine and femur bone mass, in both MEN1 PHPT and sPHPT. Evaluation of single-patient BMD changes after surgery indicates an individual variable bone mass improvement in a great majority of MEN1 PHPT patients. In MEN1 patients, PTX is strongly suggested in the presence of increased PTH and hypercalcemia to prevent/reduce the early-onset bone mass loss and grant, in young patients, the achievement of the bone mass peak; routine monitoring of bone metabolism and bone mass should start from adolescence. Therapy with anti-fracture drugs is indicated in MEN1 patients with BMD lower than the age-matched normal values.

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MARFAN'S SYNDROME (ARACHNODACTYLY)

PEDIATRICS ◽

10.1542/peds.25.5.872 ◽

1960 ◽

Vol 25 (5) ◽

pp. 872-877

Author(s):

Jerome L. Kohn ◽

Lotte Strauss

Keyword(s):

Physical Activity ◽

Early Recognition ◽

Marfan’S Syndrome ◽

Genetic Investigation ◽

Marfan's Syndrome ◽

Familial History ◽

Structural Alterations ◽

Skeletal Changes ◽

Close Observation ◽

Fatal Complications

Close observation of a patient with Marfan's syndrome throughout the duration of his life (18 years) provided an unusual opportunity to study the clinical evolution of the syndrome from birth. The diagnosis was confirmed by necropsy which showed advanced structural alterations of the cardiovascular system unsuspected during life, as well as nonspecific skeletal changes. Even in the absence of a familial history the syndrome should be suspected when arachnodactyly and excessive length are noted at birth or in the presence of accelerated longitudinal growth early in life. Notwithstanding early recognition and restriction of physical activity, the evolution of the disease could not be modified, or fatal complications prevented. While it is understood that the prognosis varies in subjects with this affliction, experience with this patient emphasizes that even in a subject with minimal or no cardiovascular symptoms the prognosis must be guarded. The Marfan syndrome may be a more common hereditary disorder than is usually realized. Present trends in research in this disease give hope that the underlying metabolic disorder may eventually be clarified. It is conceivable that a test may be developed which would not only offer a much needed diagnostic tool, but a valuable aid in genetic investigation of this disorder.

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Frontal sinus mucopyelocele with intracranial and intraorbital extension

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v3i1.4287 ◽

1970 ◽

Vol 3 (1) ◽

pp. 91-92 ◽

Cited By ~ 2

Author(s):

S Gupta ◽

R Goyal ◽

M Shahi

Keyword(s):

Ct Scan ◽

Paranasal Sinuses ◽

Frontal Sinus ◽

Visual Loss ◽

Early Recognition ◽

Surgical Excision ◽

Intracranial Extension ◽

External Approach ◽

Intracranial Complications ◽

Symptoms And Signs

This case is related to a 52-year-old lady with proptosis, diplopia and diminution of vision due to a mass lesion in upper medial quadrant of the orbit. CT scan revealed a well defined mass in basi-frontal area with intra-orbital and intracranial extension. On exploring it was found to be mucopyocele of the frontal sinus. Surgical excision was done by external approach. The symptoms and signs resolved completely within a week. Frontal sinus mucopyoceles are benign and curable. Early recognition and management of them is of paramount importance because they can expand and cause local, orbital or intracranial complications. Keywords: Mucocele; mucopyocele; paranasal sinuses; visual loss; proptosis DOI: 10.3126/nepjoph.v3i1.4287Nepal J Ophthalmol 2011;3(5):91-92

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Primary Hyperparathyroidism due to Parathyroid adenoma presenting as recurrent acute pancreatitis

Asian Journal of Medical Sciences ◽

10.3126/ajms.v8i1.15985 ◽

2017 ◽

Vol 8 (1) ◽

pp. 98-100

Author(s):

Tarun J George ◽

Pughazhendhi Thangavelu ◽

S Zahir Hussain ◽

MP Kumaran ◽

Kini Ratnakar ◽

...

Keyword(s):

Acute Pancreatitis ◽

Primary Hyperparathyroidism ◽

Parathyroid Adenoma ◽

Elevated Serum ◽

Surgical Excision ◽

Medical Sciences ◽

Thyroid Lobe ◽

Recurrent Acute Pancreatitis ◽

Hypoechoic Nodule ◽

Left Thyroid Lobe

Primary hyperparathyroidism (PHPT) due to parathyroid adenoma presenting as recurrent acute pancreatitis is a rare entity. A 17-year-old male presented with recurrent attacks of pancreatitis and was found to have elevated serum calcium and Parathyroid hormone levels, 11.9mg/dL (8.5-10.2 mg/dL) and 396 pg/ml (10-65pg/ml) respectively. USG neck showed a 1.1 x 0.9 cm hypoechoic nodule in the superior aspect of left thyroid lobe. Parathyroid scintigraphy findings were consistent with parathyroid adenoma. After recovery of pancreatitis, surgical excision of the adenoma was done and the histopathological findings confirmed parathyroid adenoma. There were no further recurrence of pancreatitis following the excision.Asian Journal of Medical Sciences Vol.8(1) 2017 98-100

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Urachal mucinous cystic tumor of low malignant potential in a polymorbid female: a case report and review of the literature

International Cancer Conference Journal ◽

10.1007/s13691-021-00530-x ◽

2022 ◽

Author(s):

Benjamin Schmeusser ◽

Joseph Wiedemer ◽

Dana Obery ◽

Kaila Buckley ◽

Michael Yu

Keyword(s):

Surgical Excision ◽

Academic Community ◽

Malignant Potential ◽

Cystic Tumor ◽

Surgical Removal ◽

Mucinous Cystic Tumor ◽

Urinary Tract Symptoms ◽

Low Malignant Potential ◽

Clinical Considerations ◽

Cure Rates

AbstractNeoplasms of the urachus are exceedingly rare, representing 0.17% of all bladder cancers. The mucinous cystic tumor of low malignant potential (MCTLMP) subtype is particularly rare with just 25 previous cases reported in the literature. Although rare, MCTLMPs are important to identify due to potential devastating complications and good cure rates with surgical removal. We present a 43 year old female with a nuanced constellation of comorbidities and confirmed MCTLMP following a workup for abdominal pain and irritative lower urinary tract symptoms. Notably, this tumor did not change in size over a 3-year course of serial imaging prior to surgical excision. This urachal MCTLMP represents roughly the 26th and one of the smallest of its subtype reported in the literature. This case illustrates the diagnosis and management of this rare urachal MCTLMP. Individual patient medical history, clinical considerations, and neoplasm characteristics are examined. Although rare, the potential for increased malignancy and potential complications necessitates surgical management and further investigation by the academic community.

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A Huge Cemento-Ossifying Fibroma of Paranasal Sinus: A Case Report

Acta Medica (Hradec Kralove Czech Republic) ◽

10.14712/18059694.2015.54 ◽

2012 ◽

Vol 55 (3) ◽

pp. 146-149

Author(s):

Ibrahim Erdim ◽

Zahide Mine Yazici ◽

Rasim Yilmazer ◽

Nurten Sever ◽

Fatma Tulin Kayhan

Keyword(s):

Case Report ◽

Paranasal Sinus ◽

Male Patient ◽

Paranasal Sinuses ◽

Surgical Excision ◽

Ossifying Fibroma ◽

Radiological Appearance ◽

Close Observation ◽

Slow Growing

Cemento-ossifying fibroma is a well-bordered, slow-growing, benign fibro-osseous disease. Although its localization is generally in the mandible, it can be seen in any area of the craniofacial region. Radiology and histopathology help to diagnose the condition. Treatment is based on close observation and/or surgical excision. In this case, we report the case of a 62-year-old male patient who had a large radiological appearance, cemento-ossifying fibroma in the paranasal sinuses.

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Abdominal Splenosis Mimicking a Colon Tumour

European Journal of Case Reports in Internal Medicine ◽

10.12890/2021_002219 ◽

2021 ◽

Author(s):

Joana Braga ◽

Francesca Pereira ◽

Cristiana Fernandes ◽

Marinha Silva ◽

Teresa Boncoraglio ◽

...

Keyword(s):

Epigastric Pain ◽

Past History ◽

Abdominal Ultrasound ◽

Splenic Tissue ◽

Surgical Removal ◽

High Morbidity ◽

Splenic Trauma ◽

Benign Condition ◽

Splenic Parenchyma ◽

Similar Sign

Splenosis is a benign condition which results from the self-implantation of splenic tissue on intra or extraperitoneal surfaces, after splenic trauma or splenectomy. Patients are usually asymptomatic but may present with varied symptoms related to the implantation site. The diagnosis is a challenge because abdominal splenosis can mimic several diseases, including neoplasm. The gold standard examination for its diagnosis is scintigraphy with 99mTc-labelled heat-denatured erythrocyte. When splenosis is found in an asymptomatic patient, surgical removal is not indicated. A 57-year-old male patient presented with sporadic epigastric pain and a suspected mass in the recto-sigmoid transition. Abdominal ultrasound, CT and MRI identified this mass, its characteristics and location, but failed to distinguish its nature. However, given the patient’s past history of splenectomy and because the mass showed a similar sign to that of the splenic parenchyma, a hypothesis of abdominal splenosis was raised, which was confirmed by scintigraphy with 99mTc-labelled heat-denatured erythrocyte. In this case, the diagnosis was obtained before the patient was subjected to more invasive procedures, which are associated with high morbidity, and, as in most cases, no targeted intervention was necessary.

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Transcanal Endoscopic Ear Surgery with Piezoelectric Device for External Auditory Canal Lesions

Korean Journal of Otorhinolaryngology - Head and Neck Surgery ◽

10.3342/kjorl-hns.2020.01109 ◽

2021 ◽

Vol 64 (7) ◽

pp. 511-516

Author(s):

Chan Young Lee ◽

Seung Ho Kim ◽

Jeong Hwan Choi

Keyword(s):

External Auditory Canal ◽

Cold Water ◽

Surgical Excision ◽

Cystic Mass ◽

Surgical Removal ◽

Ear Surgery ◽

Dental Surgery ◽

Piezoelectric Device ◽

External Auditory Canal Cholesteatoma ◽

Conductive Hearing

External auditory canal exostosis (EACE) is prone to occur in patients frequently exposed to cold water, which causes earwax impaction, recurrent otitis externa, and conductive hearing loss. The main treatment for symptomatic EACE is surgical excision. External auditory canal cholesteatoma (EACC) is a bone-destructive cystic mass caused by accumulation of plugs of desquamated keratin debris in the external auditory canal (EAC), which is also mainly treated with surgical removal. The main difficulties in the surgical removal of obstructive EACEs or EACCs are related to the adjacency of EAC skin, tympanic membrane, temporomandibular joint, and the blockage of the medial EAC landmarks during the operation. The piezoelectric device (PZD), which has long been used to cut bony structures in dental surgery, has clinical advantages here with regards to accurate exclusive bone cutting ability and minimal heat production. We report a series of cases that managed EAC lesions using PZD.

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Safety and efficacy of mini doppler in recurrent pituitary tumours

Romanian Neurosurgery ◽

10.33962/roneuro-2020-051 ◽

2020 ◽

pp. 336-342

Author(s):

Moshiur Rahman ◽

Ezequiel Garcia-Ballestas ◽

Luis Rafael Moscote-Salazar

Keyword(s):

Cavernous Sinus ◽

Surgical Excision ◽

Pituitary Surgery ◽

Pituitary Tumour ◽

Csf Leak ◽

Surgical Removal ◽

Pituitary Tumours ◽

Female Ratio ◽

Cavernous Sinus Invasion ◽

Number Of Patients

Background: Pituitary surgery is the most common surgery used to remove pituitary tumours. The use of mini doppler in surgical removal of an endonasal pituitary tumour has shown good short-term clinical outcomes and few complications in patients. Cavernous sinus invasion limits the surgical excision and still a challenge of gross total resection. Objective: The main objective of this study is to evaluate the outcome of surgical removal of an endonasal pituitary tumour using mini doppler. Method: A total of 12 patients were studied retrospectively from 2012 to 2018 in a single institution (Private hospital) in Dhaka, Bangladesh. The male and female ratio was 7:5. Results: 92% of cases of the total number of patients had satisfactory removal/ neurological improvement/hormonal improvement. Among 12 cases, 8 cases had transient diabetes insipidus and one patient had CSF leak. Conclusion: The intraoperative Doppler is a useful tool to localize the carotids, which provides safer resection of endonasal pituitary tumours. Thus, it is very safe and effective for laterosellar resection of recurrent pituitary tumours and for cavernous sinus invasions.

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