scholarly journals Bilateral giant parathyroid adenoma in the absence of multiple endocrine neoplasia type 1

2020 ◽  
Vol 102 (6) ◽  
pp. e111-e114
Author(s):  
P Liu ◽  
N Vakharia ◽  
A Zacharia ◽  
M Rogers ◽  
F Tanweer
Keyword(s):  
Parathyroid Adenoma ◽  
Multiple Endocrine Neoplasia ◽  
Kidney Injury ◽  
Test Results ◽  
Normal Range ◽  
Cross Sectional ◽  
Endocrine Neoplasia ◽  
Parathyroid Adenomas ◽  
Cross Sectional Imaging

Introduction Bilateral giant parathyroid adenoma in the absence of multiple endocrine neoplasia (MEN) type 1 is extremely rare and literature on this subject is limited. Case history A 79-year-old man presented with acute kidney injury secondary to hypercalcaemia. Blood test results indicated primary hyperparathyroidism. Ultrasonography revealed bilateral parathyroid adenomas measuring 19.4mm x 19.5mm x 18.8mm (left) and 15.2mm x 18.3mm x 19.6mm (left) whereas on computed tomography, the measurements were 31mm x 20mm (left) and 30mm x 14mm (right). Intraoperatively, giant adenomas measuring 50mm x 25mm x 12mm (left, weighing 8.101g) and 48mm x 22mm x 10mm (right, weighing 7.339g) were identified and excised. Parathyroid hormone level dropped from 44.6pmol/l preoperatively to 8.9pmol/l postoperatively (normal range 1.3–7.6pmol/l). The patient was discharged with no complications. Conclusions We report a rare phenomenon where bilateral giant parathyroid adenoma occurred in the absence of MEN type 1. It highlights the importance of cross-sectional imaging in delineating the anatomy of adenomas as their size can be grossly underestimated by ultrasonography alone.

scholarly journals Thyroid incidentalomas in patients with multiple endocrine neoplasia type 1

2015 ◽  
Vol 172 (4) ◽  
pp. 337-342 ◽  
Author(s):  
Lutske Lodewijk ◽  
Pim J Bongers ◽  
Jakob W Kist ◽  
Elfi B Conemans ◽  
Joanne M de Laat ◽  
...  
Keyword(s):  
Multiple Endocrine Neoplasia ◽  
Multiple Endocrine Neoplasia Type ◽  
Cross Sectional Study ◽  
Control Group ◽  
Thyroid Tumors ◽  
Cross Sectional ◽  
Thyroid Incidentaloma ◽  
Endocrine Neoplasia ◽  
Endocrine Neoplasia Type

ObjectiveCurrently, little is known about the prevalence of thyroid tumors in multiple endocrine neoplasia type 1 (MEN1) patients and it is unclear whether tumorigenesis of these thyroid tumors is MEN1-related. The aim of the study was to assess the prevalence of thyroid incidentalomas in MEN1 patients compared with nonMEN1 patients and to verify whether thyroid tumorigenesis is MEN1-related.DesignA cross-sectional study.MethodsThe study included two groups: patients with MEN1 and a matched non-MEN1 control group without known thyroid disease, who underwent an ultrasound of the neck for the localization of parathyroid adenoma. Ninety-five MEN1 patients underwent ultrasound of the neck and were matched on gender and age with non-MEN1 patients. The prevalence of thyroid incidentalomas described in the ultrasound report was scored. Multinodular goiters, solitary nodes, and cysts were scored as incidentalomas. Presence of nuclear menin expression was evaluated by menin immunostaining of the thyroid tumors.ResultsIn the MEN1 group, 43 (45%) patients had a thyroid incidentaloma compared with 48 (51%) in the non-MEN1 group, of which 14 (15%) and 16 (17%), respectively, were solitary nodes. Menin was expressed in the nuclei of all evaluated thyroid tumors.ConclusionsMEN1 patients do not have a higher prevalence of thyroid incidentalomas compared with primary hyperparathyroidism patients without the diagnosis of MEN1. Menin was expressed in the thyroid tumors of MEN1 patients.

scholarly journals Multiple Endocrine Neoplasia Type 1 with Concomitant Existence of Malignant Insulinoma: A Rare Finding

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Randhir Sagar Yadav ◽  
Ashik Pokharel ◽  
Deepshikha Gaire ◽  
Shumneva Shrestha ◽  
Ashbita Pokharel ◽  
...  
Keyword(s):  
Parathyroid Adenoma ◽  
Multiple Endocrine Neoplasia ◽  
Multiple Endocrine Neoplasia Type ◽  
Pancreatic Head ◽  
Pancreatic Neuroendocrine Tumor ◽  
Subtotal Parathyroidectomy ◽  
Malignant Insulinoma ◽  
Endocrine Neoplasia ◽  
Endocrine Neoplasia Type

Multiple endocrine neoplasia type 1 (MEN1) is a rare syndrome of autosomal dominant inheritance defined by co-occurrence of two or more tumors originating from the parathyroid gland, pancreatic islet cells, and/or anterior pituitary. Insulinoma which has an incidence of 0.4% is a rare pancreatic neuroendocrine tumor. Malignant insulinoma is extremely rare, while primary hyperparathyroidism is a common occurrence in MEN1. We present a case of MEN1 syndrome with 2.6 cm insulinoma in the pancreatic head and parathyroid adenoma in a 56-year-old female who presented with symptoms suggestive of hypoglycemia like multiple episodes of loss of consciousness for four years. Classical pancreaticoduodenectomy was carried out, and the postoperative period was uneventful. Later, subtotal parathyroidectomy was performed, which showed parathyroid adenoma. Patients presenting with features of hypoglycemia should be vigilantly assessed for the presence of a sinister pathology.

scholarly journals Loss of Wild-Type MEN1 Gene Expression in Multiple Endocrine Neoplasia Type 1-Associated Parathyroid Adenoma.

1999 ◽  
Vol 46 (4) ◽  
pp. 539-544 ◽  
Author(s):  
LEOPOLD LUDWIG ◽  
LOTHAR SCHLEITHOFF ◽  
HEIDI KESSLER ◽  
PETER K. WAGNER ◽  
BERNHARD O. BOEHM ◽  
...  
Keyword(s):  
Gene Expression ◽  
Parathyroid Adenoma ◽  
Multiple Endocrine Neoplasia ◽  
Multiple Endocrine Neoplasia Type ◽  
Wild Type ◽  
Men1 Gene ◽  
Endocrine Neoplasia ◽  
Endocrine Neoplasia Type

Parathyroid hormone release in vitro in hyperparathyroidism associated with multiple endocrine neoplasia type 1

1987 ◽  
Vol 114 (1) ◽  
pp. 12-17 ◽  
Author(s):  
Lars Benson ◽  
Jonas Rastad ◽  
Sverker Ljunghall ◽  
Claes Rudberg ◽  
Göran Åkerström
Keyword(s):  
Parathyroid Hormone ◽  
Multiple Endocrine Neoplasia ◽  
Multiple Endocrine Neoplasia Type ◽  
Parathyroid Glands ◽  
Men 1 ◽  
Endocrine Neoplasia ◽  
Parathyroid Adenomas ◽  
Patient Groups

Abstract. Hyperparathyroidism (HPT) in the syndrome of multiple endocrine neoplasia type 1 (MEN-1) exhibits a different picture regarding its propensity for recurrence compared with sporadic primary HPT. In order to shed further light on the MEN-1 syndrome an investigation in vitro was made of parathyroid hormone (PTH) release of dispersed parathyroid cell from 11 patients with parathyroid hyperplasia associated with MEN-1, 10 patients with single parathyroid adenomas, and 10 preparations of normal bovine parathyroid glands. The two patient groups had the same average serum calcium value prior to surgery. Immunoreactive concentrations of PTH were measured after 2-h incubations at extracellular calcium concentrations of 0.5–3.0 mmol/l. Compared with the normal bovine parathyroid cells, the cells of the MEN-1 patients had a reduced calcium sensitivity of the PTH release and secreted smaller amounts of hormone at both low and high extracellular calcium concentrations. A similar abnormality of the PTH release was found for the cells of the hyperplastic and adenomatous parathyroid glands. Although individual parathyroid glands were investigated in only three MEN-1 patients, the results suggested the secretory regulation to be less defective in the small glands of each patient. It is concluded that in patient groups matched for serum calcium, the parathyroid tissue of MEN-1 patients has an abnormality of the PTH release similar to that of parathyroid adenomas.

scholarly journals Relationship between Methaemoglobin Production and Methylene Blue Plasma Concentrations under General Anaesthesia

1986 ◽  
Vol 14 (4) ◽  
pp. 360-364 ◽  
Author(s):  
A. S. M. Lamont ◽  
M. S. Roberts ◽  
D. G. Holdsworth ◽  
A. Atherton ◽  
J. J. Shepherd
Keyword(s):  
Methylene Blue ◽  
Plasma Concentration ◽  
Multiple Endocrine Neoplasia ◽  
Multiple Endocrine Neoplasia Type ◽  
Plasma Concentrations ◽  
Family Tree ◽  
Endocrine Neoplasia ◽  
Parathyroid Adenomas ◽  
Apparent Relationship

Recently, a family tree with a predisposition for the gene of multiple endocrine neoplasia Type 1 has been identified in Tasmania. As the surgical identification and localisation of parathyroid adenomas is facilitated by the administration of methylene blue, an opportunity has presented to measure the plasma concentration of methylene blue and methaemoglobin production. The study was undertaken to establish whether significant methaemoglobin concentrations were generated during the infusion and whether these concentrations could be related to the corresponding methylene blue concentrations. Mean peak methylene blue concentrations of 3.72 μgl−1, mean percentage methaemoglobin of 10.0 and a Pa.O2 within acceptable clinical ranges were found. No apparent relationship between methylene blue concentration and methaemoglobin production was found.

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