scholarly journals Autoinfarction of Giant Parathyroid Adenoma after Preoperative Withdrawal of Anticoagulants

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Raoul Verzijl ◽  
Pim J. Bongers ◽  
Geetha Mukerji ◽  
Ozgur Mete ◽  
Karen M. Devon ◽  
...  
Keyword(s):  
Parathyroid Adenoma ◽  
Elective Surgery ◽  
Histopathological Examination ◽  
Neck Mass ◽  
Bone Lesions ◽  
Imaging Studies ◽  
Cystic Change ◽  
Parathyroid Adenomas ◽  
History Of ◽  
Brown Tumors

A 71-year-old man with known history of atrial fibrillation (treated with routine rivaroxaban therapy) was found to have incidental biochemical elevated calcium and parathyroid hormone (PTH) levels. His physical examination demonstrated the presence of a palpable right neck mass. Subsequent imaging studies revealed a large parathyroid mass as well as multiple bone lesions, raising the suspicion of parathyroid carcinoma. The anticoagulant therapy was stopped 5 days prior to his elective surgery. The night before his elective surgery, he presented to the emergency room with profound hypocalcemia. The surgery was postponed and rescheduled after calcium correction. Intraoperative findings and detailed histopathological examination revealed an infarcted 4.0 cm parathyroid adenoma with cystic change. His bony changes were related to brown tumors associated with long-standing hyperparathyroidism. Autoinfarction of a large parathyroid adenoma causing severe hypocalcemia is a rare phenomenon and may be considered in patients with large parathyroid adenomas after withdrawal of anticoagulants.

scholarly journals The Giant Parathyroid Adenoma Reaching Mediastinum: A Case Report

2021 ◽  
Author(s):  
Rahim Mahmodlou ◽  
Amin Sedokani ◽  
Bita Najafinejad
Keyword(s):  
Parathyroid Adenoma ◽  
Neck Mass ◽  
Normal Weight ◽  
Common Disease ◽  
Thyroid Mass ◽  
Parathyroid Adenomas ◽  
Chief Complaints ◽  
History Of ◽  
Old Persian ◽  
The Masses

Abstract Background: The primary hyperparathyroidism is the most common disease of parathyroid glands and the third common endocrine disease. Giant parathyroid adenoma is defined as weight > 3.5gr and size of > 2cm, however, the normal weight of the parathyroid gland is about 70mg to 1gr.Case Presentation: This report describes the most giant diagnosed primary parathyroid adenoma due to literature. The case is a 48-year-old Persian man with past medical history of mitral valve replacement and several episodes of bilateral nephrolithiasis. The chief complaints were knee and lower back pain. After complete assessment, the neck mass with possible origin of thyroid were detected and resected by surgery. The size of resected mass was 9×6×4cm weighting 122gr. The histopathological assessment revealed giant parathyroid adenoma.Conclusion: There are some reports of giant parathyroid adenoma describing the weight of up to 110gr leading to significant hypercalcemia with a size of 8cm. despite the size of the giant parathyroid adenomas and parathormone high levels, the calcium crisis may not always occur in these patients and the masses may be misdiagnosed with thyroid mass at primary assessments.

scholarly journals The Giant Parathyroid Adenoma: The largest ever reported

2021 ◽  
Author(s):  
Rahim Mahmodlou ◽  
Amin Sedokani ◽  
Apameh Pezeshk ◽  
Bita Najafinejad
Keyword(s):  
Back Pain ◽  
Parathyroid Hormone ◽  
Parathyroid Adenoma ◽  
Neck Mass ◽  
Case Presentation ◽  
Lower Back ◽  
Thyroid Mass ◽  
Parathyroid Adenomas ◽  
History Of ◽  
The Masses

Abstract BackgroundGiant parathyroid adenoma is defined as weight >3.5gr and size of more than 2cm.Case PresentationThis report describes the largest primary parathyroid adenoma according to the literature. The case is a 48-year-old man referred to the clinic with knee and lower back pain. He had a history of mitral valve replacement and several episodes of bilateral nephrolithiasis. After a thorough assessment, a neck mass with a possible thyroid origin was detected but further assessment showed it was of parathyroid origin. The resected mass was 9×6×4cm and weighed 122gr, and histopathology showed a giant parathyroid adenoma.ConclusionGiant parathyroid adenomas which weigh more than 110gr and are larger than 8cm can lead to significant hypercalcemia. Despite the size of the giant parathyroid adenomas and high parathyroid hormone levels, a calcium crisis may not always occur in these patients and the masses may be initially misdiagnosed as a thyroid mass.

scholarly journals Thyroid haemangiosarcoma in a seven-year-old female Shih Tzu

2020 ◽  
Vol 8 (2) ◽  
pp. e001012
Author(s):  
Luis Pedro Rocha Moreira ◽  
Emma Scurrell ◽  
Paul Mahoney ◽  
Stephen Baines
Keyword(s):  
Histopathological Examination ◽  
Abdominal Ultrasound ◽  
Neck Mass ◽  
Clinical Staging ◽  
Ultrasound Guided ◽  
Fine Needle ◽  
Fine Needle Aspirates ◽  
History Of ◽  
The Right ◽  
Mixed Tumours

Canine thyroid tumours are uncommon and the majority of tumours are carcinomas or adenomas, with only very few mixed tumours or metastases from distant sites described to date. A primary thyroid haemangiosarcoma has never been reported in veterinary medicine. In this case report, we describe a dog with a history of a large, non-painful, mobile ventral neck mass in the right paralaryngeal region. CT and ultrasound-guided fine needle aspirates were used for clinical staging. The mass was surgically excised and histopathological examination indicated a haemangiosarcoma. Abdominal ultrasound revealed the presence of splenic nodules and splenectomy indicated the presence of haemangiosarcoma. Chemotherapy with doxorubicin was started, but the dog was euthanased after three rounds of therapy, 97 days after the mass was discovered.

scholarly journals Clinical Behaviors of Atypical Parathyroid Adenomas

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A258-A259
Author(s):  
Sarah S Pearlstein ◽  
Kim Eric ◽  
Chomsky-Higgins Kate ◽  
Elham Khanafshar ◽  
Quan-Yang Duh
Keyword(s):  
Parathyroid Adenoma ◽  
Disease Recurrence ◽  
Neck Mass ◽  
Recurrence Rates ◽  
Parathyroid Adenomas ◽  
Long Term Follow Up ◽  
Biochemical Cure ◽  
Atypical Parathyroid Adenoma

Abstract Background: Atypical parathyroid adenoma is a rare entity that share some pathology features of parathyroid carcinoma such as fibrosis. Little is known about the clinical behavior of atypical parathyroid adenomas. Pathologically, it is defined as a hypercellular parathyroid lesion with intratumoral banding fibrosis, mitotic figures, trabecular growth and presence of tumor in the surrounding capsule but lacks unequivocal evidence of invasion, such as invasion to peritumoral vessels, perineural invasion and surrounding structures. Methods: A retrospective study of 15 consecutive patients with atypical parathyroid adenoma treated at a single center between 2010 and 2020 was performed. Patient demographics, clinical characteristics, biochemical profile, indications for surgery, preoperative localization studies, intraoperative findings, histopathological characteristics, disease recurrence or persistence and survival were collected. Results: 7 of 15 were female with a median age of 62 (IQR: 52–67). Five of the 15 patients (33%) were re-operative. No patients presented with palpable neck mass. Presentations were consistent with usual primary hyperparathyroidism. Average calcium on presentation was 11.2, and average PTH was 199. One patient had known MEN1 syndrome and one patient had family history of hyperparathyroidism but had negative genetic testing. Most patients 12/15 had correctly localizing imaging pre-operatively with the other 3 having equivocal or non-localizing studies. Two patients did not have biochemical resolution of hyperparathyroidism, both were re-operative. Of the patients with biochemical cure, 6 did not have follow up beyond 6 months, and 7 patients had long term follow up with persistent biochemical resolution and no recurrence of disease for a median of 4 years (IQR: 3.75–9.25). On review of pathology, no patients had invasive features and all patients had presence of thick fibrous bands or capsule. Conclusion: Patients with atypical adenoma have good response to surgery and low recurrence rates. Reoperation with associated scarring and fibrous bands can confound pathological findings. Our experience shows that patients found to have atypical parathyroid adenoma at their primary operation with resulting biochemical cure can be followed long-term with seemingly indolent and nonaggressive behavior.

scholarly journals RE-OPERATIVE SURGERY FOR RECURRENT PRIMARY HYPERPARATHYROIDISM ASSOCIATED WITH OLIGOMENORRHEA

2015 ◽  
Vol 2 (3) ◽  
pp. 140-143
Author(s):  
Ana Valea ◽  
V. Muntean ◽  
Andra Morar ◽  
Mara Carsote ◽  
Cristina Căpățînă ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Female Patient ◽  
Clinical Symptoms ◽  
Major Incident ◽  
Operative Surgery ◽  
Parathyroid Adenomas ◽  
History Of ◽  
Normal Calcium

Recurrent primary hyperparathyroidism is characterized by typical symptoms and biochemical recurrence of hypercalcemia after more than 6 months of normal calcium levels after surgery. We report the case of a 39-year-old female patient presenting with menses disturbances who was diagnosed with primary hyperparathyroidism caused by a left inferior parathyroid adenoma at the age of 35. Postoperative 6-month follow-up showed normalization of biochemical and hormonal profiles, with significant improvement of clinical symptoms, dominated by muscle weakness, weight loss and oligomenorrhea. The 18-month follow-up showed elevated PTH and serum calcium levels. Imaging confirmed recurrence of primary hyperparathyroidism by highlighting a right upper parathyroid adenoma. Surgery was performed again and no major incident was seen. The particularity of this case consists in the recurrence of primary hyperparathyroidism in a young patient with no family history of the disease due to asynchronous parathyroid adenomas that were successfully removed in a female patient who in addition to classic complications such as calyceal microlithiasis and osteoporosis presented oligomenorrhea which was resolved spontaneously after the correction of hypercalcemia.

Escisión transcervical de un adenoma paratiroideo mediastínico gigante

2021 ◽  
Vol 64 (2) ◽  
pp. 38-45
Author(s):  
Isaías Adrián Barrientos López ◽  
◽  
Bertha Beatriz Castillo Ventura ◽  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Thyroid Lobe ◽  
Selective Treatment ◽  
Case Presentation ◽  
Parathyroid Adenomas ◽  
History Of ◽  
Thyroid Profile ◽  
The Right ◽  
Similar Location

Primary hyperparathyroidism (HPTP) is the third most common neuroendocrine disorder, its main cause is parathyroid adenoma. Within the classification, those adenomas that weigh more than 3.5 g are classified as giant parathyroid adenomas (APG), and are associated with a worse evolution and malignancy. The purpose of this article is to present our diagnostic and therapeutic approach of a patient with HPTP ssociated with a mediastinal APG. A search in the international literature of the last 10 years revealed that only 8 other centers ha ve reported the extraction of an APG of similardimensions to ours and in a similar location. Case presentation: A 66-year-old woman with a history of multinodular goiter, thyroid profile and parathormone (PTH) measurement were requested, with a report of 350.60 pg/mL. A thyroid/parathyroid scintigraphy was performed with 99mTc sestaMIBI which reported persistence of a focal area of the concentration located in the topography of the lower pole of the right thyroid lobe. This study was complemented with SPECT-CT, which reported an image of hyperfunctioning right inferior parathyroid compatible with adenoma and the patient was diagnosed with PTH. Finally, resection was performed, obtaining a tumor measuring 7.0 × 4.5 × 2.0 cm, with a weight of 24.5 g. Conclusions: Our case highlights the use of imaging studies to facilitate localization and achieve diagnosis together with clinical presentation and biochemical profile. Selective treatment was achieved safely through a minimally invasive transcervical technique, combined with the measurement of PTH. Keywords: Parathyroid adenoma; neoplasia; hypercalcemia; primary hyperparathyroidism; case report.

scholarly journals An Unusual Differential Diagnosis of Orbital Cavernous Hemangioma: Ancient Schwannoma

2017 ◽  
Vol 8 (2) ◽  
pp. 294-300 ◽  
Author(s):  
Sara Filipa Teixeira Ribeiro ◽  
Tatiana Queirós ◽  
José M. Amorim ◽  
Ana M. Ferreira ◽  
Marco Sales-Sanz
Keyword(s):  
Differential Diagnosis ◽  
Cavernous Hemangioma ◽  
Histopathological Examination ◽  
Imaging Studies ◽  
Complete Excision ◽  
Bone Changes ◽  
Tumoral Lesion ◽  
History Of ◽  
Degenerative Alterations

Schwannomas are rare lesions of the orbit that can be confused with cavernous hemangioma on imaging studies. We report the case of an 84-year-old woman with a 9-year history of a tumoral lesion in the inferolateral left orbit. The imaging studies did not reveal specific characteristics, only bone remodeling due to the long evolution of the tumor. The patient underwent complete excision of the tumor by anterior orbitotomy via the inferior conjunctival fornix. The histopathological examination revealed an ancient schwannoma, a variant of schwannoma with uncommon histological features. The follow-up was uneventful. The present case emphasizes the importance of considering neural tumors in the differential diagnosis of orbital masses with bone changes and degenerative alterations such as hemorrhagic areas, cysts, and/or calcifications.

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 Abdominopelvic Actinomycosis Mimicking Peritoneal Carcinomatosis: A Case Report

2020 ◽  
Vol 36 (6) ◽  
pp. 417-420
Author(s):  
Sungjin Kim ◽  
Sung Il Kang ◽  
Sohyun Kim ◽  
Min Hye Jang ◽  
Jae Hwang Kim
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Peritoneal Carcinomatosis ◽  
Histopathological Examination ◽  
Lower Abdominal Pain ◽  
Preoperative Imaging ◽  
Imaging Studies ◽  
Complete Excision ◽  
Pelvic Masses ◽  
History Of

Actinomycosis is a rare chronic bacterial infection primarily caused by <i>Actinomyces israelii</i>. A 47-year-old woman presented to our clinic with a 1-week history of lower abdominal pain. Preoperative imaging studies revealed multiple peritoneal and pelvic masses suggestive of malignancy. The primary tumor could not be identified despite further endoscopic and gynecological evaluation. On exploration for tissue confirmation, excisional biopsies from multiple masses were performed because complete excision was not possible. Histopathological examination confirmed actinomycosis with multiple abscesses, and the patient was treated with antibiotics. We present a case of disseminated peritoneal actinomycosis that mimicked malignant peritoneal carcinomatosis on imaging studies.

scholarly journals Intrathyroid parathyroid adenoma: report of two cases and literature review

2020 ◽  
Vol 8 (11) ◽  
pp. 4096
Author(s):  
Camilo Levi Acuna Pinzon ◽  
Eduardo Morales Valencia ◽  
Jefferson Nieves Condoy ◽  
Luis Abraham Zuniga Vasquez ◽  
Arturo Jorge Sotelo
Keyword(s):  
Literature Review ◽  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Clinical Suspicion ◽  
Definitive Treatment ◽  
Preoperative Period ◽  
Imaging Studies ◽  
High Clinical Suspicion ◽  
Parathyroid Adenomas ◽  
Ectopic Parathyroid

Approximately 80% of patients with primary hyperparathyroidism have a parathyroid adenoma, with surgery being the only definitive treatment. Sometimes in surgery there is difficulty in identifying the pathological parathyroid gland at which time the possibility of ectopic parathyroid should be considered. We present two cases of patients which after hemithyroidectomy histopathological report, reported intrathyroid parathyroid adenoma. Intrathyroid parathyroid adenomas are an infrequent presentation of parathyroid adenomas that require high clinical suspicion if they are not detected by imaging studies in the preoperative period.

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