scholarly journals Nontraumatic Parapharyngeal Haematoma: A Rare Lesion

2018 ◽  
Vol 2018 ◽  
pp. 1-2 ◽  
Author(s):  
Pedro Carneiro de Sousa ◽  
Inês Gambôa ◽  
Delfim Duarte ◽  
Nuno Trigueiros-Cunha
Keyword(s):  
Case Report ◽  
Parathyroid Hormone ◽  
Conservative Treatment ◽  
Parathyroid Adenoma ◽  
Parapharyngeal Space ◽  
Neck Swelling ◽  
Parathyroid Adenomas ◽  
Rare Lesion ◽  
Symptoms And Signs ◽  
Emergent Surgery

Nontraumatic haematoma of parapharyngeal space is very rare and may cause dysphagia and dyspnea. The authors present a case report of a 74-year-old woman with sudden nontraumatic neck swelling without dyspnea and with left pharyngeal bulging and endolaryngeal displacement. Parathyroid hormone elevation and imaging exams confirmed bleeding from a parathyroid adenoma. Symptoms and signs resolved after one week of conservative treatment. There are few cases of parapharyngeal haematomas caused by parathyroid adenomas. Most patients can be managed without emergent surgery, but close airway monitoring is fundamental.

Parathyroid hormone excess due to denosumab application and concomitant parathyroid adenoma with an atypical scintigraphic pattern- a case report

2019 ◽  
Author(s):  
Dimitrios Askitis ◽  
Michail Karanikas ◽  
Nikolaos Michalopoulos ◽  
Aphroditi Strataki ◽  
Athanasios Zissimopoulos
Keyword(s):  
Case Report ◽  
Parathyroid Hormone ◽  
Parathyroid Adenoma

An occult ectopic parathyroid adenoma in a pediatric patient: a case report and management algorithm

2017 ◽  
Vol 30 (9) ◽  
Author(s):  
Brent D. Bauman ◽  
Maria Evasovich ◽  
Amanda Louiselle ◽  
Eugene Zheng ◽  
Kevin Goodwin ◽  
...  
Keyword(s):  
Case Report ◽  
Parathyroid Adenoma ◽  
Pediatric Patient ◽  
Pediatric Population ◽  
Preoperative Imaging ◽  
Management Algorithm ◽  
Postoperative Mri ◽  
Complex Patients ◽  
Multiple Imaging ◽  
Parathyroid Adenomas

AbstractBackground:Hyperparathyroidism (HPT) is a rare disease in the pediatric population, and optimal management may be unclear if it is due to an occult parathyroid adenoma. We present a case report of a pediatric patient with an occult, ectopic, supernumerary, parathyroid adenoma.Case presentation:A 13-year-old female who initially presented with anxiety was diagnosed with HPT. Preoperative imaging and bilateral neck exploration with four-gland biopsy were negative for any parathyroid adenoma. Postoperative MRI identified a thymic mass. She subsequently underwent video-assisted thoracoscopic thymectomy with resection of an intrathymic parathyroid adenoma.Conclusions:The diagnosis of pediatric HPT is increasing. Supernumerary or occult parathyroid adenomas are rare and add complexity to presurgical planning and management. Our case represents the rare occurrence of a pediatric ectopic supernumerary occult parathyroid adenoma treated with a two-stage approach utilizing multiple imaging studies. We provide a review of the pathology and propose an algorithmic approach to manage these complex patients.

Mediastinal, Cystic and Functional Parathyroid Adenoma in Patients with Double Parathyroid Adenomas: a Case Report

2006 ◽  
Vol 106 (6) ◽  
pp. 736-738 ◽  
Author(s):  
M. Ogus ◽  
B. Mayir ◽  
A. Dinckan
Keyword(s):  
Case Report ◽  
Parathyroid Adenoma ◽  
Parathyroid Adenomas

A CASE OF RECURRENT PARATHYROID ADENOMA – A CASE REPORT

2021 ◽  
pp. 27-28
Author(s):  
C. Aparna ◽  
P.Venkata Kiran Kumar ◽  
Shaila Shaila ◽  
Lakshmi Soundarya
Keyword(s):  
Case Report ◽  
Parathyroid Adenoma ◽  
Male Patient ◽  
Muscle Weakness ◽  
Clinical History ◽  
Parathyroid Adenomas ◽  
Laboratory Investigations ◽  
Microscopic Picture

Parathyroid adenomas(PTH) are rare lesions. We report a case of recurrent parathyroid adenoma in a 28 year old male patient. He was operated for parathyroid adenoma, right inferior parathyroid was removed ten years bsck. Now he presented with extreme muscle weakness and renal calcinosis. Entire clinical history, laboratory investigations, microscopic picture are discussed in detail.

scholarly journals Atypical Parathyroid Adenoma in a Young Man

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A182-A182
Author(s):  
Elizabeth R Bowen ◽  
Joseph Stephen Dillon
Keyword(s):  
Parathyroid Hormone ◽  
Parathyroid Adenoma ◽  
Mitotic Activity ◽  
Parathyroid Carcinoma ◽  
Sudden Onset ◽  
Lytic Lesion ◽  
Brown Tumor ◽  
Adjacent Structures ◽  
Parathyroid Adenomas ◽  
Atypical Parathyroid Adenoma

Abstract Patient is a 38-year-old man who developed sudden onset of pain in the upper left arm while carrying a case of water. The pain recurred periodically over the next few months. He presented to the emergency department where imaging showed a pathologic fracture in the proximal left humerus through a lytic lesion. Laboratory testing showed: calcium 13.8 mg/dL (8.5–10.1 mg/dL), 25-OH vitamin D 8 ng/mL (31–100 ng/mL), parathyroid hormone 1583.1 pg/mL (18.5–88 pg/mL). Neck ultrasound showed a complex nodule in the left neck measuring 4.2 x 1.7 x 2.5 cm. Subsequent biopsy of the left arm lesion showed a Brown tumor. The patient was referred to endocrinology. There was concern for parathyroid carcinoma given the elevated parathyroid hormone and large neck lesion. Technetium-99m sestamibi scan showed a 4.1 x 2.6 x 2.5 cm mass posterior to the left thyroid lobe. He subsequently underwent left hemithyroidectomy and parathyroidectomy. Pathology revealed a 3.1 cm parathyroid mass with scattered fibrous bands, foci of prominent nucleoli and foci of sheet-like trabecular and spindled architecture. It was without necrosis, lymphovascular invasion, perineural invasion, increased mitotic activity, atypical mitoses or invasion into adjacent structures. Thus, it was classified as an atypical parathyroid adenoma. Primary hyperparathyroidism is the third most common endocrine disorder, but fewer than 2% occur as a result of an atypical parathyroid adenoma. Patients with an atypical parathyroid adenoma tend to have a more dramatic clinical presentation compared to those with classic adenoma. We see higher calcium and parathyroid hormone levels. Atypical parathyroid adenomas are classified as such due to other features which place the lesion at a higher risk for malignant behavior including higher mitotic activity, adherence to adjacent structures, banding fibrosis and a growth pattern that is either solid or trabecular. In contrast to parathyroid carcinoma, atypical parathyroid adenomas do not show invasion into the surrounding tissues or lymphatic/vascular vessels, and there should be no evidence of metastatic disease. The exact definition of an atypical parathyroid adenoma varies among institutions, and recognition of the defining features (or lack thereof) necessitates an experienced endocrine pathologist. Due to their uncertain malignant potential, patients with an atypical parathyroid adenoma should undergo routine surveillance for recurrence. Routine follow-up of calcium, parathyroid hormone and imaging is indicated to detect for recurrence. A CDC73 germline mutation is associated with recurrence compared to CDC73-negative patients. Parafibromin expression is also thought to play a role although studies so far have had discrepant results.

scholarly journals Can Surgeons Use Parathyroid Hormone Levels as Predictive Value in Parathyroid Adenomas?

2021 ◽  
Vol 4 (3) ◽  
pp. 1-2
Author(s):  
Merve Tokocin ◽  
Talar Vartanoglu Aktokmakyan ◽  
Ahmet Guray Durmaz ◽  
Onur Tokocin ◽  
Huseyin Bilge ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Parathyroid Adenoma ◽  
Predictive Value ◽  
Positive Association ◽  
Moderate Correlation ◽  
Ipth Level ◽  
Gland Weight ◽  
Parathyroid Adenomas ◽  
The Mean ◽  
The Relationship

Aim: Previous studies using different methods for PTH measurement have found a mild to moderate correlation between iPTH and gland weight. The aim of this study was to describe the relationship between parathyroid hormone and parathyroid adenoma volume, in patients with parathyroid adenomas as predictive value. Material and Methods: The multicenteric study was prepared by retrospectively collecting data from 244 patients with parathyroid adenoma who underwent parathyroidectomy and followed up between 2010 and 2020. Results: Two hundred forty and four (female/male = 203/41) patients with a mean age of 51.41 [min-max: 17 to 88] years. The mean iPTH concentrations preoperatively were 584.27 ng/L [min-max: 18.9 to 5011ng/L]. The mean diameter of adenoma of patients was 2,865 mm3 [min-max: 0.119 to 42.3 mm3]. After parathyroidectomy, PTH values were reevaluated and found as 47.2 ng/L [min-max: 0.2 to 903 ng/L]. In the patients with large parathyroid adenoma volume, preoperative PTH hormone values were statistically significantly higher (p=0.001). Conclusion: Our current study found a positive association between baseline iPTH levels and adenoma weight. These results suggest that serum iPTH level may be useful in predicting parathyroid adenoma volume.

scholarly journals Sudden Odynophagia and Globus—A Unique Presentation of a Nonsecreting Parathyroid Adenoma: A Case Report and Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Luxman Srikantha ◽  
Esmael H. Amjad ◽  
Rafic Beydoun
Keyword(s):  
Case Report ◽  
Parathyroid Adenoma ◽  
Clinical Symptoms ◽  
Surgical Excision ◽  
Laryngeal Nerve ◽  
Range Imaging ◽  
Normal Range ◽  
Parathyroid Adenomas ◽  
The Right ◽  
Point Tenderness

Parathyroid adenomas are most commonly diagnosed when symptoms consistent with primary hyperparathyroidism arise. However, certain parathyroid glands may enlarge without such symptoms. Described here is a case in which a patient presented with acute signs of unilateral cervical point tenderness, dysphagia, and odynophagia. Calcium and parathyroid hormone levels tested within normal range. Imaging revealed an enlarged right-sided mass, with compression of the trachea-esophageal groove and potentially the right recurrent laryngeal nerve. Surgical excision was performed, and final pathology revealed an infarcted parathyroid adenoma. Clinical symptoms promptly resolved thereafter. Current NIH criteria for parathyroidectomy include various symptoms of hyperparathyroidism but do not include the above findings. Nonsecreting parathyroid adenomas rarely cause laryngeal symptoms, as this has only been documented once before.

scholarly journals An unusual case of brown tumor of hyperparathyroidism associated with ectopic parathyroid adenoma

2013 ◽  
Vol 07 (04) ◽  
pp. 500-503 ◽  
Author(s):  
Mathan Mohan ◽  
Ravana Sundaram Neelakandan ◽  
D. Siddharth ◽  
Ravi Sharma
Keyword(s):  
Case Report ◽  
Parathyroid Hormone ◽  
Parathyroid Adenoma ◽  
Unusual Case ◽  
Brown Tumor ◽  
Thyroxine Therapy ◽  
Giant Cell Lesion ◽  
Ectopic Parathyroid Adenoma ◽  
Calcium Phosphorus ◽  
Ectopic Parathyroid

ABSTRACTBrown tumor is a giant cell lesion associated with hyperparathyroidism. It is a non-neoplastic condition and represents terminal stage of the remodeling process in hyperparathyroid state. We report a case of brown tumor with multiple lesions in craniofacial region associated with ectopic parathyroid adenoma revealed after acute L-thyroxine poisoning. This case report emphasizes on the need for routine biochemical investigations along with serum calcium, phosphorus and parathyroid hormone levels in patients on thyroxine therapy.

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 Autofluorescence pattern of parathyroid adenomas

BJS Open ◽  
2021 ◽  
Vol 5 (1) ◽  
Author(s):  
M S Demarchi ◽  
W Karenovics ◽  
B Bédat ◽  
C De Vito ◽  
F Triponez
Keyword(s):  
Parathyroid Hormone ◽  
Surgical Treatment ◽  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Sensitivity And Specificity ◽  
Near Infrared ◽  
Parathyroid Tissue ◽  
Endocrine Surgery ◽  
Parathyroid Adenomas ◽  
Tissue Sensitivity

Abstract Background Primary hyperparathyroidism (pHPT) is a common endocrine pathology, and it is due to a single parathyroid adenoma in 80–85 per cent of patients. Near-infrared autofluorescence (NIRAF) has recently been used in endocrine surgery to help in the identification of parathyroid tissue, although there is currently no consensus on whether this technique can differentiate between normal and abnormal parathyroid glands. The aim of this study was to describe the autofluorescence pattern of parathyroid adenoma in pHPT. Methods Between January and June 2019, patients with pHPT who underwent surgical treatment for parathyroid adenoma were enrolled. Parathyroid autofluorescence was measured. Results Twenty-three patients with histologically confirmed parathyroid adenomas were included. Parathyroid adenomas showed a heterogeneous fluorescence pattern, and a well defined autofluorescent ‘cap’ region was observed in 17 of 23 specimens. This region was on average 28 per cent more fluorescent than the rest of the adenoma, and corresponded to a rim of normal histological parathyroid tissue (sensitivity and specificity 88 and 67 per cent respectively). After resection, all patients were treated successfully, with normal postoperative values of calcium and parathyroid hormone documented. Conclusion Parathyroid adenomas show a heterogeneous autofluorescence pattern. Using NIRAF imaging, the majority of specimens showed a well defined autofluorescent portion corresponding to a rim of normal parathyroid tissue. Further studies should be conducted to validate these findings.

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