A large parathyroid adenoma presenting with pathological fractures in a young male

Parathyroid adenoma is the common cause of primary hyperparathyroidism and usually presents with features of hypercalcaemia. In the present case report, we describe a case of a large adenoma of the parathyroid gland presenting with pathological fractures. A 42 year old Male presented with bony pains and fracture of the left humerus after a trivial trauma. A detailed clinical examination and laboratory studies revealed hypercalcaemia secondary to hyperparathyroidism. The patient underwent targeted parathyroidectomy of the involved gland after appropriate preoperative localization. Histopathology of the resected specimen was consistent with parathyroid adenoma. Conclusion is a common cause of primary hyperparathyroidism is a common endocrine disorder occurring as a result of Parathyroid adenoma in 80-85% cases. Patients usually present with symptoms related to hypercalcaemia. A high index of suspicion, careful preoperative workup, localization of the affected gland(s) and surgical excision ensures a successful cure.

Download Full-text

Parathyroid Adenoma Presenting with Recurrent Abdominal Pain and Renal Calculi

Nepalese Journal of ENT Head and Neck Surgery ◽

10.3126/njenthns.v6i1.19438 ◽

2018 ◽

Vol 6 (1) ◽

pp. 20-21

Author(s):

Dipendra Gautam ◽

Ishwor Raj Devkota ◽

Sandesh Mainali ◽

Bijaya Kumar Chaudhari

Keyword(s):

Abdominal Pain ◽

Case Report ◽

Primary Hyperparathyroidism ◽

Parathyroid Adenoma ◽

Renal Colic ◽

Renal Calculi ◽

Recurrent Abdominal Pain ◽

Neck Surgery ◽

Present Case Report ◽

Common Cause

Introduction: Parathyroid adenoma is the single most common cause of hyperparathyroidism. Reported incidence of parathyroid adenoma varies widely and is 30- 90%. Approximately 80% to 85% of patients with primary hyperparathyroidism were found to have solitary parathyroid adenoma.The hyperparathyroidism due to parathyroid adenoma may progress insidiously over several years and eventually presents as renal colic or symptoms may manifest over a considerably shorter period of time. Greater than 50% of patients present with nephrolithiasis or nephrocalcinosis. The present case report describes a 48 year old male patient with symptoms of abdominal pain.Nepalese Journal of ENT Head and Neck Surgery, Vol. 6, No. 1, 2015

Download Full-text

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

Download Full-text

Primary hyperparathyroidism on the example of a 33-year-old female patient with parathyroid adenoma

Polish Journal of Surgery ◽

10.5604/01.3001.0013.4519 ◽

2019 ◽

Vol 91 (5) ◽

pp. 1-5

Author(s):

Jarosław Łach ◽

Michał Dyaczyński ◽

Krzysztof Buczkowski

Keyword(s):

Primary Hyperparathyroidism ◽

Kidney Stones ◽

The Body ◽

Pathological Fractures ◽

Common Cause ◽

Latent Form ◽

Paroxysmal Tachycardia ◽

Men 1 ◽

Metallic Taste ◽

Men 2A

Parathyroid hyperactivity is the state of over-production and PTH secretion [1]. The most common cause of primary hyperparathyroidism is parathyriod adenoma - about 80% of cases, the remaining are parathyroid hyperplasia around 15%cases [2] [3], and in 1-5% of cases, cancer [2] [3] [4] [5]. The disease is diagnosed inabout 40 people in 100,000 [5] [6] [3] [7]. The most common cause of adenoma is the mutation in gene MEN 1. Less than 5% of cases are chronichyperparathyroidism, which is a component of the MEN 1 MEN 2a endocrine adenocarcinoma syndrome [1]. Excess PTH in the body leads to increased mobilization of calcium from the bones, and henceincreased osteolysis, what also increases the absorption of calcium from thedigestive system, as well as an increased amount of phosphate excretion in the urine. Clinical picture of the disease is multiform and often runs in a latent form. Most often the diseaseoccurs in the form of osteoporosis, chronic recurrent kidney stones, and is also commonpyelonephritis on the basis of urolithiasis. The disease may be accompanied by: dysphagia, abdominal pain, metallic taste in the mouth, persistent constipation. In addition, from the systemnervous: dizziness and headaches, disturbances of consciousness. Arrhythmia the form of additional contractions and paroxysmal tachycardia. Osteolysis, osteoporosis and pathological fractures [1]. The purpose of this article is to bring closer to the reader case of 33 years old woman with primary hyperparathyroidism on the adenoma.

Download Full-text

A Case Report on Recurrent Acute Pancreatitis with Primary Hyperparathyroidism

Faridpur Medical College Journal ◽

10.3329/fmcj.v11i1.30879 ◽

2016 ◽

Vol 11 (1) ◽

pp. 36-38

Author(s):

Mukesh Prasad Sah ◽

Dewan Saifuddin Ahmed ◽

Syeda Nur E Jannat ◽

Md Alamgir Kabir ◽

Muhammad Rezeul Huq ◽

...

Keyword(s):

Acute Pancreatitis ◽

Primary Hyperparathyroidism ◽

Parathyroid Adenoma ◽

Calcium Concentration ◽

Viral Infections ◽

Recurrent Acute Pancreatitis ◽

Common Cause ◽

Severe Pancreatitis ◽

Gall Stones ◽

Common Causes

Pancreatitis is a common non-bacterial inflammatory disease caused by activation, interstitial liberation and auto digestion of pancreas by its own enzymes. Common causes of acute pancreatitis are gall stones, alcohol, drugs, trauma, viral infections and hypertriglyceridemia. Much is known about the causes of pancreatitis but huge experimental data available about understanding of its pathogenesis is still incomplete. Hypercalcemia as a cause of pancreatitis is rarely reported. Hypercalcemia is usually the result of Primary hyperparathyroidism (PHPT) and the most common cause of PHPT is parathyroid adenoma. It is thought that the increased calcium concentration in pancreatic juice resulting from hypercalcemia may prematurely activate proteases. Mutations in different genes have been proposed as well to justify why only some patients with primary hyperparathyroidism and hypercalcemia develop acute pancreatitis. Here we present a case of recurrent acute pancreatitis resulting from hypercalcemia due to parathyroid adenoma in a 38-year-old man. Hyperparathyroidism was suspected when despite severe pancreatitis calcium level remained high and parathormone level was grossly raisedFaridpur Med. Coll. J. Jan 2016;11(1): 36-38

Download Full-text

PERIPHERAL OSSIFYING FIBROMA OF MANDIBULAR ANTERIOR GINGIVA IN A YOUNG BOY – A CASE REPORT

Clinical Dentistry ◽

10.33882/clinicaldent.14.25798 ◽

2020 ◽

Author(s):

Jayachandran S ◽

Sophia Jeba Priya ◽

Archana M

Keyword(s):

Case Report ◽

Clinical Presentation ◽

Young Male ◽

Surgical Excision ◽

Ossifying Fibroma ◽

Oral Lesions ◽

Peripheral Ossifying Fibroma ◽

Complete Surgical Excision ◽

Fourth Decade ◽

The Common

Peripheral ossifying fibroma is one of the common reactive oral lesions which accounts for about 9.6% of all gingival lesions. There is a predilection for females in the second to fourth decade of life. Most lesions are less than 2 cm in size, although larger ones occasionally occur. The raised lesion may appear smooth or ulcerated and most often is caused by constant irritation or trauma. The growth-like clinical presentation may lead to misclassification; however, the histologic appearance is quite diagnostic for this lesion. In this case report we are discussing the case of a young male patient with peripheral ossifying fibroma in the mandibular anterior region which was managed by complete surgical excision. Key Words: Peripheral ossifying fibroma, reactive lesion, mandibular gingiva

Download Full-text

Parathyroid Adenoma - From Surgical to Biochemical Cure

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/374 ◽

2021 ◽

Vol 10 (23) ◽

pp. 1809-1814

Author(s):

Rupa Mehta ◽

Nitin M. Nagarkar ◽

Satish S.S. ◽

Ripu Daman Arora ◽

Jyoti Ranjan Das

Keyword(s):

Primary Hyperparathyroidism ◽

Secondary Hyperparathyroidism ◽

Parathyroid Adenoma ◽

Parathyroid Gland ◽

Neck Mass ◽

The Body ◽

Parathyroid Glands ◽

Posterior Aspect ◽

Biochemical Cure ◽

High Index Of Suspicion

Parathyroid glands, minute endocrine glands, located in posterior aspect of thyroid glands secrete parathormone which plays an important role in maintaining calcium homeostasis in the body. The superior and inferior parathyroid glands originate from the 4th and 3rd branchial pouches respectively and migrate to occupy their normal positions in relation to the thyroid gland.1 Hyperparathyroidism is defined as hyper functioning of parathyroid gland and can be primary, secondary or tertiary. Primary hyperparathyroidism is due to parathyroid gland proliferative disorders which include parathyroid adenoma, parathyroid hyperplasia, parathyroid carcinoma or in association with other conditions in MEN syndrome. In more than 90 % patients, primary hyperparathyroidism is caused by a single parathyroid adenoma. Very rarely double parathyroid adenomas are seen. Secondary Hyperparathyroidism is caused in response to any chronic hypocalcaemic conditions like renal failure, gastrointestinal malabsorption, dietary rickets & drugs, like phenytoin, phenobarbital & laxative. Prolonged secondary hyperparathyroidism leads to tertiary hyperparathyroidism due to autonomous secretion. The clinical presentation of hyperparathyroidism is classically described as kidney stones, abdominal groans, painful bones, psychic moans, and fatigue overtones. In the initial course of the disease, the patients present with vague symptoms of fatigue, muscle and joint pain, frequent urination, nausea, constipation, and decreased appetite. If high index of suspicion is maintained, they can be conveniently diagnosed by routine blood tests which show increased calcium levels. However, in India still majority of people are diagnosed when they present with palpable neck mass, skeletal manifestations or deranged renal function. We hereby present 5 cases of parathyroid adenoma managed at our centre over a period of 2 years. P

Download Full-text

Hypercalcemia induced pancreatitis as a rare presentation of primary hyperparathyroidism

Acta Gastro Enterologica Belgica ◽

10.51821/84.2.367 ◽

2021 ◽

Vol 84 (2) ◽

pp. 367-370

Author(s):

V Desmedt ◽

S Desmedt ◽

E D’heygere ◽

G Vereecke ◽

W Van Moerkercke

Keyword(s):

Acute Pancreatitis ◽

Abdominal Pain ◽

Case Report ◽

Primary Hyperparathyroidism ◽

Parathyroid Adenoma ◽

Inflammatory Process ◽

High Morbidity ◽

Rare Presentation ◽

Common Cause ◽

Upper Abdominal

Acute pancreatitis (AP) is an inflammatory process of the pancreas. It is a relatively common cause of acute upper abdominal pain and is potentially associated with high morbidity and mortality. Underlying hypercalcemia as a cause of AP is very rare. We present a case of a hypercalcemia-induced acute pancreatitis with an underlying parathyroid adenoma in an 81-year-old woman with no previous symptoms of hypercalcemia. The parathyroid adenoma was semi-urgently surgically resected with normalization of calcium-levels. This case report summarizes the causes of acute pancreatitis and hypercalcemia and its management.

Download Full-text

SAT-LB308 Primary Hyperparathyroidism and Meningioma as a Part of Multiple Endocrine Neoplasm Type 1 (MEN Type 1)

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.2279 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Shady Ibrahim ElEbrashy ◽

ElRefaay Ehab

Keyword(s):

Primary Hyperparathyroidism ◽

Parathyroid Adenoma ◽

Histopathological Examination ◽

Surgical Excision ◽

Tracer Uptake ◽

Whole Body ◽

Genetic Studies ◽

Pet Ct

Abstract Background: Meningioma is a rare association of Multiple endocrine neoplasia type 1 (MEN 1) and very few cases has been reported in literature. Clinical Case: a 75-year-old woman showed severe headache, disturbed consciousness and convulsions. A diagnosis of cerebral meningioma was made and surgical excision was done, histopathological examination confirmed meningioma; patient was transferred to the ICU postoperatively for monitoring. Patient’s consciousness was not regained in full and remained in delirium, follow up investigations revealed: serum calcium of 13.2 mg/dl (8.5 to 10.5 mg/dl), serum sodium 141 mmol/L (135-145 mmol/L) and potassium 4.9 mmol/L (3.5-5 mmol/L), serum parathormone of 850 pg/mL (10-65 pg/mL), primary hyperparathyroidism was suspected; further investigations revealed inferior parathyroid adenoma on ultrasound which elicited focal tracer uptake on sesta-mibi parathyroid scintigraphy. Patient did excision of the lesion and was confirmed by histopathological examination to be parathyroid adenoma. Patient recovered well postoperatively, consciousness was regained and no neurological defects ware present. Genetic studies where performed and was found positive for MEN type 1 gene. Whole body Ga-DOTATATE PET/CT was then done to exclude any associated tumors and no tracer uptake was found. Patient was discharged, family members were offered genetic analysis and were counselled on the importance of screening. Conclusion: MEN type 1 can rarely present with meningiomas with symptoms very similar and easily confused with hypercalcemia and the diagnosis can be missed.

Download Full-text

Urachal fistula in a 22 year male: a case report

International Surgery Journal ◽

10.18203/2349-2902.isj20203813 ◽

2020 ◽

Vol 7 (9) ◽

pp. 3102

Author(s):

Vipul Kumar Srivastava ◽

Shilpi Roy ◽

Ram Niwas Meena ◽

Rahul Khanna

Keyword(s):

Fistulous Tract ◽

Young Male ◽

Rare Condition ◽

Surgical Excision ◽

Purulent Discharge ◽

Patent Urachus ◽

Low Incidence ◽

High Index Of Suspicion ◽

Urachal Fistula ◽

Specific Symptoms

A patent urachus is one of the spectrums of congenital urachal anomalies. It has been termed as "urachal fistula" when the lumen of intra-embryonic portion of allantois persist abnormally. Persisting urachal fistula is a rare condition mostly diagnosed during childhood or in autopsies. Here we report a very rare case of urachal fistula of a young male. We present a case of 22 years male with intermittent periumbilical pain and sero-purulent discharge from umbilicus since birth. On examination sero-purulent discharging umbilical sinus with granuloma was present. Surgical excision of whole of the urachal fistulous tract was done with repair of bladder. Patient did well during post-operative period. Persisting urachal fistula in adult is rare entity and difficult to diagnose because of low incidence and non-specific symptoms. So a high index of suspicion is required in order to make the early diagnosis of urachal anomalies.

Download Full-text