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BMJ Case Reports Mar 2015Undescended parathyroid adenomas are rare, representing 0.08% of all parathyroid adenomas; however, they make up 7% of the underlying cause of failed cervical...
Undescended parathyroid adenomas are rare, representing 0.08% of all parathyroid adenomas; however, they make up 7% of the underlying cause of failed cervical exploration in patients with persistent primary hyperparathyroidism. A 43-year-old woman with no significant medical or family history presented with fatigue and was diagnosed with primary hyperparathyroidism; however, preoperative imaging including sestamibi scan and ultrasound was unable to identify the hyperfunctioning gland. She underwent a neck exploration and hemithyroidectomy and partial parathyroidectomy with failure of resolution of her disease. Subsequent work up including a CT of the neck demonstrated a 1.9 cm mass adjacent to the left submandibular gland. This was removed with postoperative normalisation of the patient's serum calcium and parathyroid hormone levels.
Topics: Adenoma; Adult; Female; Humans; Hyperparathyroidism; Hyperparathyroidism, Primary; Parathyroid Neoplasms; Parathyroidectomy; Treatment Outcome
PubMed: 25737222
DOI: 10.1136/bcr-2014-208277 -
Journal of the American Animal Hospital... Jan 2023A 10 yr old female spayed domestic shorthair was referred for an 11mo history of persistent total hypercalcemia and elevated ionized calcium with intermittent episodes...
A 10 yr old female spayed domestic shorthair was referred for an 11mo history of persistent total hypercalcemia and elevated ionized calcium with intermittent episodes of lethargy, vomiting, and diarrhea with a history of recurrent urinary tract infections and intermittently elevated kidney values. An abdominal ultrasound, thoracic radiographs, cervical ultrasound, and ionized calcium level, parathyroid hormone (PTH), and PTH-related peptide (PTHrp) levels were assessed. Results were consistent with chronic kidney disease, splenomegaly, diffuse thickening of small intestines, nodular lesions noted in the left thyroid and right parathyroid, and elevated ionized calcium, PTH, and elevated PTHrp levels. A left thyroidectomy and right cranial parathyroidectomy were performed. Hypocalcemia and anemia developed postoperatively, which were managed with calcium carbonate, calcitriol, and calcium gluconate and benign neglect of anemia. Histopathology was consistent with a left thyroid carcinoma and right cranial parathyroid adenoma. Thyroid carcinoma and parathyroid adenomas have not previously been reported to occur concurrently in domestic felines and should be considered when ionized calcium is elevated with both PTH and PTHrp levels increased in addition to ultrasonographic lesions.
Topics: Cats; Animals; Female; Parathyroid Hormone-Related Protein; Parathyroid Neoplasms; Calcium; Parathyroid Hormone; Hypercalcemia; Thyroid Neoplasms; Cat Diseases
PubMed: 36584312
DOI: 10.5326/JAAHA-MS-7299 -
BMJ Case Reports Apr 2021Giant parathyroid adenomas are rare and underreported benign tumours of parathyroid gland. Preoperative differentiation between giant parathyroid adenoma (GPA) and...
Giant parathyroid adenomas are rare and underreported benign tumours of parathyroid gland. Preoperative differentiation between giant parathyroid adenoma (GPA) and parathyroid carcinoma can be challenging, as they both may present as a large parathyroid tumour with hyperparathyroidism. Very few GPAs had been described in the literature, with only 60 cases including our present case. We report a case of GPA and the preoperative diagnostic challenges we faced in differential diagnosis of a potential parathyroid malignancy. As a parathyroid malignancy could not be excluded preoperatively the parathyroid tumour was excised en bloc with surrounding thyroid lobe. The histology was contributory to exclude parathyroid malignancy confirming a benign GPA.
Topics: Adenoma; Humans; Hyperparathyroidism; Parathyroid Glands; Parathyroid Neoplasms; Parathyroidectomy
PubMed: 33837034
DOI: 10.1136/bcr-2021-241554 -
Kathmandu University Medical Journal... 2011Primary Hyperparathyroidism is most commonly caused by parathyroid adenoma. Parathyroid adenoma is generally suspected by certain symptoms and biochemical abnormalities....
Primary Hyperparathyroidism is most commonly caused by parathyroid adenoma. Parathyroid adenoma is generally suspected by certain symptoms and biochemical abnormalities. They rarely attain large size to be evident clinically. We report a rare case of giant parathyroid adenoma measuring 5 x 4 x 3 cm and weighing 35 gm.
Topics: Adenoma; Female; Humans; Hyperparathyroidism, Primary; Middle Aged; Parathyroid Hormone; Parathyroid Neoplasms
PubMed: 22610816
DOI: 10.3126/kumj.v9i1.6269 -
Medicina Clinica Sep 2023
Topics: Humans; Parathyroid Neoplasms; Hemorrhage; Hematoma
PubMed: 37316388
DOI: 10.1016/j.medcli.2023.05.003 -
BMJ Case Reports Feb 2023Primary hyperparathyroidism (PHPT) is the most common cause of hypercalcaemia and is caused by a single parathyroid adenoma in the neck in 85% or more of patients....
Primary hyperparathyroidism (PHPT) is the most common cause of hypercalcaemia and is caused by a single parathyroid adenoma in the neck in 85% or more of patients. National Institute for Health and Care Excellence (NICE) guidelines published in May 2019 advise that preoperative imaging is offered prior to parathyroid surgery for PHPT if it will inform surgical approach. If imaging, typically a neck ultrasound and a second modality that may use ionising radiation, does not identify the adenoma or is discordant, it is advised that surgery is performed by a surgeon with expertise in the management of unlocalised parathyroid disease.The cure rate in such cases is over 96%. Occasionally, however, PHPT cure can be challenging.A woman in her late 40s presented with bilateral renal calculi and was found to have PHPT. Following false positive imaging and three non-curative surgical procedures, removal of a supernumerary ectopic parathyroid adenoma in the aortopulmonary window via sternotomy achieved definitive cure.
Topics: Female; Humans; Parathyroid Neoplasms; Parathyroidectomy; Neck; Diagnostic Imaging; Parathyroid Glands; Parathyroid Hormone
PubMed: 36759046
DOI: 10.1136/bcr-2022-250380 -
Advances in Experimental Medicine and... 2022Primary hyperparathyroidism (PHPT) secondary to parathyroid gland adenoma is mildly symptomatic and thus often incidentally diagnosed. In this report, we present a case...
Primary hyperparathyroidism (PHPT) secondary to parathyroid gland adenoma is mildly symptomatic and thus often incidentally diagnosed. In this report, we present a case of a 46-year-old man who was treated for hypertension and other nonspecific complaints. An elevated level of blood calcium led to the suspicion of parathyroid adenoma. Technetium-99m-methoxyisobutylisonitrile (Tc-MIBI) planar and single-photon emission computed tomographic scintigraphy (SPECT/CT) confirmed the presence of a 10-mm-wide adenoma behind the sternal handle in the anterior mediastinum. The tumor was excised by Kocher's cervical access along with the right and left upper horns of the thymus gland and was histologically confirmed as being of parathyroid nature. However, blood parathyroid hormone and calcium remained persistently elevated. Repeated scintigraphy imaging revealed the presence of another retrosternal tracer focus at the level of Ludwig's angle. The patient was reoperated with the longitudinal sternotomy access, and thymus remnants, parathymic nodule, and fragments of mediastinal fat and right parietal pleura were removed. On the second postoperative day, parathyroid hormone and calcium reverted to normal values, but the patient remained hypertensive. Despite the successful surgical treatment, the patient remained hypertensive suggesting that the underlying reason was a familial hypertensive disease rather than parathyroid adenoma. In conclusion, this report underscores the need for diagnostic vigilance in the case of persisting hypercalcemia with hypertension and diagnostic and surgical difficulties in the management of ectopic PHPT secondary to parathyroid gland adenomas.
Topics: Humans; Hyperparathyroidism, Primary; Male; Middle Aged; Parathyroid Glands; Parathyroid Neoplasms; Radiopharmaceuticals; Technetium Tc 99m Sestamibi; Tomography, Emission-Computed, Single-Photon
PubMed: 34970729
DOI: 10.1007/5584_2021_698 -
The Laryngoscope Aug 2022
Topics: Adenoma; Humans; Parathyroid Glands; Parathyroid Neoplasms; Radionuclide Imaging; Technetium Tc 99m Sestamibi
PubMed: 34751975
DOI: 10.1002/lary.29937 -
Head & Neck Dec 2015Intraneural parathyroid adenomas are rare, with only 9 cases of intravagal adenomas reported. All but one of the reported cases was found after multiple neck...
BACKGROUND
Intraneural parathyroid adenomas are rare, with only 9 cases of intravagal adenomas reported. All but one of the reported cases was found after multiple neck explorations. To the best of our knowledge, we report the first case of nonsupernumerary ectopic intravagal parathyroid identified at primary exploration.
METHODS AND RESULTS
A 17-year-old girl with primary hyperparathyroidism and nephrolithiasis was referred with a sestamibi scan reporting a left lower parathyroid adenoma. No eutopic parathyroid tissue was identified during full exploration of the left side of the neck. Exploration of the carotid sheath revealed a fusiform swelling of the vagus nerve at the level of the carotid bifurcation. Longitudinal incision of the vagal perineurium revealed a 7-mm parathyroid adenoma, which was enucleated. The patient recovered uneventfully, with normalization of serum calcium, parathyroid hormone (PTH), and normal vocal cord function.
CONCLUSION
We believe that this is the first reported case of nonsupernumerary intravagal parathyroid adenoma resected at initial exploration. The vagus nerve is a rare location for a parathyroid adenoma, but one that should be considered, even during primary exploration.
Topics: Adenoma; Adolescent; Choristoma; Female; Humans; Hyperparathyroidism, Primary; Parathyroid Neoplasms; Treatment Outcome; Vagus Nerve
PubMed: 25867456
DOI: 10.1002/hed.24068 -
Ear, Nose, & Throat Journal Aug 2023Parathyroid adenomas are responsible for 80% to 85% of cases of primary hyperparathyroidism. Giant parathyroid adenomas are a rare type of parathyroid adenoma defined as...
Parathyroid adenomas are responsible for 80% to 85% of cases of primary hyperparathyroidism. Giant parathyroid adenomas are a rare type of parathyroid adenoma defined as weighing >3.5 grams. Although giant parathyroid adenomas are rare entities whose clinical presentation may not be atypical, their surgical management can be challenging, especially in the setting of anatomical variants. We present here a case of a 29-year-old female with a 37-gram giant adenoma which was diagnosed after presentation with recurrent severe headaches. The presentation was also unique in that it was associated with a right aberrant subclavian artery and nonrecurrent laryngeal nerve.
Topics: Female; Humans; Adult; Parathyroid Neoplasms; Laryngeal Nerves; Cardiovascular Abnormalities; Subclavian Artery
PubMed: 34044628
DOI: 10.1177/01455613211020959