scholarly journals Parathyroid adenoma in third pharyngeal pouch cyst as a rare case of primary hyperparathyroidism

2014 ◽  
Vol 96 (7) ◽  
pp. e8-e10 ◽  
Author(s):  
S Salido ◽  
J Gómez-Ramírez ◽  
JM Bravo ◽  
E Martín-Pérez ◽  
G Fernández-Díaz ◽  
...  
Keyword(s):  
Parathyroid Adenoma ◽  
Anterior Mediastinum ◽  
Pathological Examination ◽  
Cervical Mass ◽  
Superior Mediastinum ◽  
Parathyroid Adenomas ◽  
Branchial Cleft Anomalies ◽  
Branchial Cleft ◽  
Inferior Parathyroid Gland ◽  
Third Pharyngeal Pouch

The primitive thymus and inferior parathyroid derive from the third branchial cleft. During embryonic development, these structures descend, reaching their final localisation. Third branchial cleft anomalies present usually as a fistula, abscess or cyst. However, there are no reports on parathyroid adenomas in the literature other than as a morphological possibility. We describe the case of a 47-year-old man, who had been diagnosed with arterial hypertension and who presented with a cervical mass at the edge of the lower third of the sternocleidomastoid muscle. On ultrasonography, the mass had a cystic walled appearance. Laboratory analysis only revealed an intact parathyroid hormone level of 140.5pg/ml. Sestamibi imaging showed a probable parathyroid adenoma in the anterior mediastinum. During surgery, a tract running from beyond the superior thyroid pedicle to the superior mediastinum was dissected and removed. In the inferior end of the tract, a brown mass was visible. Pathological examination revealed a thymus cyst surrounding a parathyroid adenoma. The primal alteration was the lack of division between the thymus and inferior parathyroid gland, and the prompt prevention of their development. In the case of our patient, a parathyroid adenoma had grown by chance.

scholarly journals Thoracoscopic surgical case of an ectopic mediastinal parathyroid adenoma detected by chance: a case report

BMC Surgery ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Shota Mitsuboshi ◽  
Hideyuki Maeda ◽  
Hiroe Aoshima ◽  
Tamami Isaka ◽  
Takako Matsumoto ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Parathyroid Adenoma ◽  
Serum Calcium ◽  
Tumor Resection ◽  
Anterior Mediastinum ◽  
Pathological Examination ◽  
Cervical Approach ◽  
History Of ◽  
Mediastinal Parathyroid Adenoma ◽  
Mediastinal Parathyroid

Abstract Background Ectopic mediastinal parathyroid tumor (EMPT) is a rare cause of primary hyperparathyroidism (PHPT); it is difficult to resect using the cervical approach. We describe a case of using video-assisted thoracic surgery (VATS) for EMPT resection. Case presentation A 67-year-old woman with a history of postoperative thyroid cancer had no symptoms. She was diagnosed with PHPT and underwent thyroid cancer surgery. She had serum calcium and intact parathyroid hormone (PTH) levels of 11.1 mg/dL and 206 pg/mL, respectively. Chest computed tomography showed a 10-mm nodule in the anterior mediastinum. Technetium-99 m methoxyisobutyl isonitrile scintigraphy showed an abnormal uptake lesion in the anterior mediastinum. She was diagnosed with PHPT caused by EMPT and underwent VATS. The pathological examination confirmed parathyroid adenoma. Her serum calcium and intact PTH levels were normal from 15 min after tumor resection. She has had no recurrence of EMPT. Conclusions The VATS approach was effective for the resection of EMPT.

scholarly journals Undescended retropharyngeal parathyroid adenoma with adjacent thymic tissue in a 13-year-old boy with primary hyperparathyroidism

2019 ◽  
Vol 2019 (12) ◽  
pp. 519-523 ◽  
Author(s):  
Anthony M Kordahi ◽  
Ron S Newfield ◽  
Stephen W Bickler ◽  
Jun Q Mo ◽  
Paritosh C Khanna ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Ct Scan ◽  
Parathyroid Adenoma ◽  
Pharyngeal Pouch ◽  
Rare Presentation ◽  
Thymic Tissue ◽  
The Third ◽  
Parathyroid Adenomas ◽  
Preoperative Ct ◽  
Third Pharyngeal Pouch

ABSTRACT We describe a rare presentation of a symptomatic parathyroid adenoma located in an ectopic retropharyngeal position in a 13-year-old boy. Preoperative CT scan and MRI demonstrated the ectopic location of the parathyroid adenoma. The patient underwent successful parathyroidectomy with cure of his hyperparathyroidism. On pathologic exam, the specimen was made up of a parathyroid adenoma and adjacent thymic tissue, indicating that it was likely an undescended lower parathyroid gland arising from the third pharyngeal pouch. Ectopic retropharyngeal parathyroid adenomas are very rare and to our knowledge, none have been previously described in adolescents.

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 Adult Ectopic Cervical Thymic Tissue in relation to a Parathyroid Adenoma and a Papillary Thyroid Carcinoma: A Report of Two Cases

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Vijay Shrawan Nijhawan ◽  
Roopali Sehrawat ◽  
Neeti Goyal ◽  
Manish Gupta
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Parathyroid Adenoma ◽  
Parathyroid Gland ◽  
Early Years ◽  
Pathological Examination ◽  
Papillary Thyroid ◽  
Thymic Tissue ◽  
Macroscopic Appearance ◽  
Inferior Parathyroid Gland

Ectopic cervical thymus is a rare congenital anomaly, which results because of the failure of complete descent of the thymus. They are incidental findings in the young and may disappear during the early years of life; however, they have rarely been described in adults. Some of them may undergo hyperplasia or neoplastic transformation and become visible or cause symptoms. We report two rare cases of incidentally detected cervical thymic tissue in adults. In one case, the thymic tissue was seen adjacent to a parathyroid adenoma of the left inferior parathyroid gland. In the other, it was seen adjacent to the left inferior parathyroid gland in a case of papillary thyroid carcinoma. In both these cases, the ectopic thymic tissue was diagnosed as a result of pathological examination, not clinically by macroscopic appearance during operation or radiological evaluation. The finding needs to be noted as these ectopic foci can occasionally give rise to hyperplasia and neoplasms of the thymus.

Intraoperative use of fibrin glue dyed with methylene blue in surgery for branchial cleft anomalies

2016 ◽  
Vol 126 (9) ◽  
pp. 2147-2150 ◽  
Author(s):  
Michela Piccioni ◽  
Marco Bottazzoli ◽  
Nader Nassif ◽  
Stefania Stefini ◽  
Piero Nicolai
Keyword(s):  
Methylene Blue ◽  
Fibrin Glue ◽  
Branchial Cleft Anomalies ◽  
Branchial Cleft

Branchial cleft and pouch anomalies

1992 ◽  
Vol 106 (2) ◽  
pp. 137-143 ◽  
Author(s):  
G. R. Ford ◽  
A. Balakrishnan ◽  
J. N. G. Evans ◽  
C. M. Bailey
Keyword(s):  
Recurrent Infection ◽  
Theoretical Description ◽  
The Other ◽  
Unexpected Finding ◽  
Neck Swelling ◽  
Complete Excision ◽  
Delay In Diagnosis ◽  
Branchial Cleft Anomalies ◽  
Branchial Cleft ◽  
Sick Children

AbstractWe present a retrospective study of 106 patients with branchial cleft and pouch anomalies who presented to the Hospital for Sick Children between 1948 and 1990. The relevant embryology of the branchial apparatus is summarized and a theoretical description of individual anomalies given.Second branchial cleft sinuses were the most common anomalies, and the majority were managed simply, with adequate excision and a low recurrence rate. Five cases of first branchial cleft anomalies are presented, emphasizing the delay in diagnosis, the need for complete excision to prevent recurrence, and for a parotidectomy incision to protect the facial nerve from damage. The two third branchial pouch anomalies presented with a cystic neck swelling, one with recurrent infection and discharge, and the other with stridor. In both, the diagnosis was made at operation. The single fourth branchial pouch cyst was an unexpected finding in a patient with stridor.

Do patients with atypical parathyroid adenoma need a close follow-up?

2021 ◽  
Author(s):  
Federica Saponaro ◽  
Elena Pardi ◽  
Laura Mazoni ◽  
Simona Borsari ◽  
Liborio Torregrossa ◽  
...  
Keyword(s):  
Parathyroid Adenoma ◽  
Serum Calcium ◽  
Good Prognosis ◽  
Histopathological Diagnosis ◽  
Symptomatic Disease ◽  
Asymptomatic Patients ◽  
Parathyroid Adenomas ◽  
Relevant Role ◽  
Atypical Parathyroid Adenoma

Abstract Context Atypical parathyroid adenomas (APAs) are neoplasms with uncertain malignant potential but lack unequivocal histological signs of malignancy. Objective To retrospectively evaluate the clinical and biochemical profiles of patients with APA, the outcome after parathyroidectomy (PTX), and the presence of CDC73 germline and somatic mutations. Design Monocentric study on consecutive patients undergoing PTX for primary hyperparathyroidism (PHPT) between June 2000 and December 2020. Patients Fifty-eight patients with a confirmed histopathological diagnosis of APA. Age and sex-matched controls with parathyroid adenoma (PA) were also included. Results Fifty-four patients had sporadic PHPT and four familial isolated hyperparathyroidism (FIHP). Thirty-four patients (59%) had a symptomatic disease. Serum calcium and PTH levels were significantly higher in symptomatic compared to asymptomatic patients (P=0.048 and 0.008, respectively). FIHP patients were younger than the sporadic counterpart (30±17yr vs. 55±13 yrs). APA patients had significantly higher serum calcium and PTH levels and lower 25(OH)D concentration, BMD and T-score at 1/3 distal radius compared to those with PA. Four of 56 APA patients displayed a CDC73 germline mutation. No somatic CDC73 mutation was identified in 24 tumor specimens. The mean follow-up after surgery was of 60±56.4 months. All but six patients (90%), five with apparently sporadic PHPT and one with FIHP, were cured after surgery. Conclusions The large majority of patients with APA, despite a moderate/severe phenotype, have a good prognosis. Germline CDC73 mutation-positive patients had a higher rate of persistent/recurrent disease. CDC73 gene alterations do not seem to have a relevant role in the tumorigenesis of sporadic APA.

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.

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.

scholarly journals The “dimple swallow” sign for branchial cleft anomalies

2018 ◽  
Vol 190 (44) ◽  
pp. E1307-E1307
Author(s):  
Petros Koltsidopoulos ◽  
Charalampos Skoulakis
Keyword(s):  
Branchial Cleft Anomalies ◽  
Branchial Cleft
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