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The American Surgeon Nov 2011
Topics: Aged; Biopsy, Fine-Needle; Cysts; Diagnosis, Differential; Female; Follow-Up Studies; Humans; Parathyroid Diseases; Sclerotherapy; Suction; Tomography, Emission-Computed, Single-Photon
PubMed: 22196644
DOI: No ID Found -
Otolaryngologic Clinics of North America Feb 2024The management of thyroid and parathyroid pathology varies widely, with unifying goals of symptomatic control and mitigating patient morbidity. In general, surgery is... (Review)
Review
The management of thyroid and parathyroid pathology varies widely, with unifying goals of symptomatic control and mitigating patient morbidity. In general, surgery is indicated when addressing malignancy or when medical management is insufficient. Over the last few decades, treatment paradigms for patients with head and neck endocrine disease have shifted significantly as our understanding of disease processes has expanded and with the advent of numerous relevant technologies. Here we provide a general overview of thyroid and parathyroid disease that may be managed by the otolaryngologist, with attention to emerging strategies in diagnosis and treatment.
Topics: Humans; Thyroid Gland; Parathyroid Diseases; Otolaryngology; Thyroid Nodule; Treatment Outcome
PubMed: 37648633
DOI: 10.1016/j.otc.2023.07.003 -
Vojnosanitetski Pregled Nov 2015Parathyroid cysts are relative rare and they may be misdiagnosed with thyroid nodules. Parathyroid cysts are characterized by elevated level of parathyroid hormone (PTH)...
INTRODUCTION
Parathyroid cysts are relative rare and they may be misdiagnosed with thyroid nodules. Parathyroid cysts are characterized by elevated level of parathyroid hormone (PTH) in cystic fluid. CASE REPORT. We reported about middle-aged woman with palpable node in the left thyroid lobe. Ultrasound showed anechoic 40 x 25 mm lesion in the left thyroid lobe. Fine needle aspiration (FNA) obtained 13 mL colorless, watery cystic fluid. PTH value in cystic fluid was ten fold more in comparison with serum PTH. Serum PTH was slightly elevated, D vitamin was under the reference range, serum calcium and phosphorus were normal as well as thyroid hormones. Thyroglobulin antibodies (TgAb) and thyroid peroxidase antibodies (TPOAb) were not detected. Radionuclide parathyroid scintigraphy indicated at physiological metaiodbenzyl-guamidine (MIBG) distribution. After six monthsof vitamin D supplementation, serum calcium, phosphorus, vitamin D and PTH were normal. This finding was indicative that was a nonfunctional parathyroid cyst.
CONCLUSION
This case report points out that thyroid cystic lesions with thin walls, and reverberation in ultrasound, must be observed as a potential parathyroid cyst. These cysts require caution during diagnostic aspiration because of danger of hypercalcemic crises due to FNA, which can be a life-threatening condition.
Topics: Adult; Biomarkers; Biopsy, Fine-Needle; Cysts; Diagnosis, Differential; Diagnostic Imaging; Female; Humans; Parathyroid Diseases
PubMed: 26731979
DOI: 10.2298/vsp140624103p -
European Archives of... Dec 2010The consideration of surgery during pregnancy requires weighing the benefit of urgent surgery against the risk to mother and fetus. Surgery during pregnancy involves an... (Review)
Review
The consideration of surgery during pregnancy requires weighing the benefit of urgent surgery against the risk to mother and fetus. Surgery during pregnancy involves an increase in both maternal and fetal risks. Thyroid and parathyroid surgery involves physiological risks to both mother and fetus specific to the disease and function of these endocrine glands. Evaluation of a thyroid mass is similar in pregnant patients with ultrasound and fine-needle aspiration biopsy providing the most important information, while the use of radiographic imaging is severely constrained except when specifically required. In general, thyroid surgery can be delayed until after delivery except in cases of airway compromise or aggressive cancer. In contrast, parathyroid surgery is recommended during pregnancy to avoid adverse effects to the neonate.
Topics: Female; Humans; Infant, Newborn; Parathyroid Diseases; Pregnancy; Pregnancy Complications; Risk Assessment; Thyroid Diseases; Treatment Outcome
PubMed: 20878196
DOI: 10.1007/s00405-010-1390-0 -
European Journal of Endocrinology Sep 2019PARAT, a new European Society of Endocrinology program, aims to identify unmet scientific and educational needs of parathyroid disorders, such as primary... (Review)
Review
PARAT, a new European Society of Endocrinology program, aims to identify unmet scientific and educational needs of parathyroid disorders, such as primary hyperparathyroidism (PHPT), including parathyroid cancer (PC), and hypoparathyroidism (HypoPT). The discussions and consensus statements from the first PARAT workshop (September 2018) are reviewed. PHPT has a high prevalence in Western communities, PHPT has a high prevalence in Western communities, yet evidence is sparse concerning the natural history and whether morbidity and long-term outcomes are related to hypercalcemia or plasma PTH concentrations, or both. Cardiovascular mortality and prevalence of low energy fractures are increased, whereas Quality of Life is decreased, although their reversibility by treatment of PHPT has not been convincingly demonstrated. PC is a rare cause of PHPT, with an increasing incidence, and international collaborative studies are required to advance knowledge of the genetic mechanisms, biomarkers for disease activity, and optimal treatments. For example, ~20% of PCs demonstrate high mutational burden, and identifying targetable DNA variations, gene amplifications and gene fusions may facilitate personalized care, such as different forms of immunotherapy or targeted therapy. HypoPT, a designated orphan disease, is associated with a high risk of symptoms and complications. Most cases are secondary to neck surgery. However, there is a need to better understand the relation between disease biomarkers and intellectual function, and to establish the role of PTH in target tissues, as these may facilitate the appropriate use of PTH substitution therapy. Management of parathyroid disorders is challenging, and PARAT has highlighted the need for international transdisciplinary scientific and educational studies in advancing in this field.
Topics: Education; Endocrinology; Europe; Humans; Hyperparathyroidism, Primary; Parathyroid Diseases; Parathyroid Hormone; Parathyroid Neoplasms; Societies, Medical
PubMed: 31176307
DOI: 10.1530/EJE-19-0316 -
Chirurgia (Bucharest, Romania : 1990) 2011Parathyroid cysts are a rare medical condition, that is why they represent a diagnostic and therapeutic challenge for the practitioner. The cysts are often small in... (Review)
Review
Parathyroid cysts are a rare medical condition, that is why they represent a diagnostic and therapeutic challenge for the practitioner. The cysts are often small in diameter, measuring a few millimeters, but in some cases they are centimetric in size. There are 2 types of parathyroid cysts, according to their activity: the nonfunctioning (essential) and the functioning (adenomatous) forms, the last one being responsible of hyperparathyroidism. We report a case of nonfunctioning symptomatic parathyroid cyst in a 36-year old woman revealed by an anterior cervical tumefaction focusing on the pre-operative diagnosis and the management of it regarding the various therapeutic methods described in the literature.
Topics: Adult; Cysts; Female; Humans; Parathyroid Diseases; Rare Diseases; Treatment Outcome
PubMed: 21520778
DOI: No ID Found -
Endocrine Practice : Official Journal... 2001To describe a patient with extracapsular parathyroid hemorrhage and review the signs and symptoms of this condition. (Review)
Review
OBJECTIVE
To describe a patient with extracapsular parathyroid hemorrhage and review the signs and symptoms of this condition.
METHODS
We report a case of extracapsular parathyroid hemorrhage in a patient with primary hyperparathyroidism and present an overview of previously reported cases.
RESULTS
A 48-year-old woman with documented primary hyperparathyroidism, who was awaiting surgical intervention, had acute onset of a neck mass, neck pain, and dysphagia. She was found to have sustained a spontaneous extracapsular hemorrhage of a parathyroid adenoma. Hypercalcemia persisted, and she subsequently underwent curative parathyroidectomy for the primary hyperparathyroidism. We also identified 15 previously reported cases of extracapsular parathyroid hemorrhage and summarized the most common manifestations-most notably, a neck mass or swelling, ecchymoses of the neck and chest, dysphagia, neck pain, hoarseness, and dyspnea.
CONCLUSION
Clinicians should be aware of the potential for occurrence of extracapsular parathyroid hemorrhage in patients with primary hyperparathyroidism. When this condition occurs, severe hypercalcemia or acute hypocalcemia may be present. Hypercalcemia is often persistent; however, autoinfarction of the parathyroid adenoma is possible.
Topics: Adenoma; Female; Hemorrhage; Humans; Hypercalcemia; Hyperparathyroidism; Middle Aged; Parathyroid Diseases; Parathyroid Neoplasms; Tomography, X-Ray Computed
PubMed: 11250766
DOI: 10.4158/EP.7.1.32 -
Veterinary Radiology & Ultrasound : the... 2000The purpose of this study was to evaluate the utility of double-phase parathyroid scintigraphy using 99mTc-sestamibi for detecting and localizing hyperfunctioning...
The purpose of this study was to evaluate the utility of double-phase parathyroid scintigraphy using 99mTc-sestamibi for detecting and localizing hyperfunctioning parathyroid glands in hypercalcemic dogs. Fifteen hypercalcemic dogs that underwent parathyroid scintigraphy were included in this study: 3 dogs with hypercalcemia of malignancy, and 12 dogs with hyperfunctioning parathyroid tissue (parathyroid adenoma or parathyroid hyperplasia). The presence of parathyroid adenoma or parathyroid hyperplasia was documented by histopathologic examination. In 3 dogs with hypercalcemia of malignancy, parathyroid scintigraphy was negative for hyperfunctioning parathyroid tissue and the scans were classified as true negative. Parathyroid scintigraphy correctly identified the presence and location of hyperfunctioning parathyroid tissue in only 1 of 6 dogs with a parathyroid adenoma. False positive and false negative results occurred in dogs with parathyroid adenomas. Parathyroid scintigraphy failed to detect hyperfunctioning parathyroid tissue in 5 of 6 dogs with parathyroid hyperplasia and were classified as false negative. False positive results were obtained in the remaining dog with parathyroid hyperplasia. Sensitivity of parathyroid scintigraphy for detecting and localizing hyperfunctioning parathyroid tissue was 11%, specificity was 50%, and overall accuracy was 27%. Positive and negative predictive value were 25% and 27%, respectively. Sensitivity for detection of parathyroid adenomas was 25%, and sensitivity for detection of hyperplastic glands was 0 %. Results of this study indicate that double-phase parathyroid scintigraphy does not appear to have acceptable accuracy in detecting hyperfunctioning parathyroid glands in dogs. Due to the poor sensitivity and specificity of the technique in dogs, parathyroid scintigraphy is not recommended for definitive identification of abnormal parathyroid glands as the cause of hypercalcemia in dogs.
Topics: Animals; Dog Diseases; Dogs; False Negative Reactions; False Positive Reactions; Parathyroid Diseases; Radionuclide Imaging; Sensitivity and Specificity; Technetium Tc 99m Sestamibi
PubMed: 11052372
DOI: 10.1111/j.1740-8261.2000.tb01872.x -
Journal of Nuclear Medicine Technology Mar 1997Scintigraphy of the parathyroid glands continues to be controversial from several standpoints, including radiopharmaceutical choice, imaging protocol, results, and... (Review)
Review
Scintigraphy of the parathyroid glands continues to be controversial from several standpoints, including radiopharmaceutical choice, imaging protocol, results, and utility in clinical situations. This article reviews: the anatomy, physiology and pathology of the parathyroid glands; mechanisms of radiopharmaceutical localization; commonly accepted imaging protocols; image results; and the appropriate use of parathyroid scintigraphy.
Topics: Humans; Image Enhancement; Iodine Radioisotopes; Parathyroid Diseases; Parathyroid Glands; Parathyroid Neoplasms; Radionuclide Imaging; Radiopharmaceuticals; Sensitivity and Specificity; Sodium Pertechnetate Tc 99m; Technetium Tc 99m Sestamibi; Thallium Radioisotopes
PubMed: 9239607
DOI: No ID Found -
Otolaryngologic Clinics of North America Dec 2010Four-gland parathyroid exploration has been the gold standard for parathyroid surgery until recently. Emphasis is now placed on minimally invasive and focused...
Four-gland parathyroid exploration has been the gold standard for parathyroid surgery until recently. Emphasis is now placed on minimally invasive and focused parathyroidectomy. In conjunction with functional sestamibi scanning, ultrasonography permits accurate localization of enlarged parathyroid glands in the vast majority of patients with hyperparathyroidism. Consequently, ultrasound technology applied to parathyroid pathology facilitates directed surgical therapy and minimally invasive applications. As such, ultrasonography holds great promise as a tool that enables cost-effective and advanced patient care.
Topics: Adenoma; Humans; Hyperparathyroidism, Primary; Minimally Invasive Surgical Procedures; Parathyroid Diseases; Parathyroid Glands; Parathyroid Neoplasms; Parathyroidectomy; Sensitivity and Specificity; Ultrasonography
PubMed: 21044738
DOI: 10.1016/j.otc.2010.08.002