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Annales D'endocrinologie May 2015
Review
Topics: Adenoma; Four-Dimensional Computed Tomography; Humans; Magnetic Resonance Imaging; Parathyroid Diseases; Parathyroid Glands; Parathyroid Neoplasms; Tomography, X-Ray Computed; Ultrasonography
PubMed: 25936463
DOI: 10.1016/j.ando.2015.04.001 -
Endocrine Practice : Official Journal... Feb 2016
Topics: Anxiety Disorders; Cysts; Depression; Diagnosis, Differential; Disease Progression; Hemorrhage; Humans; Hyperparathyroidism; Male; Middle Aged; Parathyroid Diseases; Ultrasonography
PubMed: 26523623
DOI: 10.4158/EP15908.VV -
Ear, Nose, & Throat Journal Mar 2018
Topics: Cysts; Female; Humans; Mediastinum; Middle Aged; Parathyroid Diseases; Tomography, X-Ray Computed; Ultrasonography
PubMed: 29554397
DOI: 10.1177/014556131809700318 -
Nihon Rinsho. Japanese Journal of... Apr 1995Parathyroid cysts are grouped into two: functioning and non-functioning cysts. Most of the functioning cysts result from the cystic degeneration of parathyroid adenoma,... (Review)
Review
Parathyroid cysts are grouped into two: functioning and non-functioning cysts. Most of the functioning cysts result from the cystic degeneration of parathyroid adenoma, while, non-functioning cysts, in many cases, originate from Kürsteiner's canal on the third branchial cleft. It is difficult to differentiate parathyroid from thyroid cysts morphologically. However, the measurement of assay of parathyroid and thyroid hormone in the aspirated fluid enables differentiation. Hypercalcemic crisis occurs frequently in the functioning cysts. Moreover, we propose sclerotherapy as the treatment for the non-functioning cysts.
Topics: Cysts; Diagnosis, Differential; Humans; Parathyroid Diseases; Sclerotherapy
PubMed: 7752459
DOI: No ID Found -
Zeitschrift Fur Rheumatologie Nov 2011Parathyroid dysfunction, leading to severe clinical symptoms and radiographic changes, has decreased over the last years due to routine laboratory checks including serum...
Parathyroid dysfunction, leading to severe clinical symptoms and radiographic changes, has decreased over the last years due to routine laboratory checks including serum calcium levels. Thus, abnormal calcium levels are detected early in the course of the disease and the underlying cause treated accordingly. Hyperparathyroidism often leads to osteoporosis and low-trauma fractures. When evaluating secondary osteoporosis analysis of calcium, phosphate and intact parathyroid hormone levels are mandatory. Osteitis fibrosa cystica and brown tumors are less frequent findings of hyperparathyroidism. However, in patients with arthritis or bone symptoms, hyperparathyroidism has to be evaluated as a possible reason. Other manifestations of hyperparathyroidism include myopathy, tendon ruptures and unspecific symptoms of the muscles and skeleton. Gout as well as pseudogout may be associated with hyperparathyroidism. Hypoparathyroidism may cause musculoskeletal diseases mimicking ankylosing spondylitis or diffuse idiopathic skeletal hyperostosis. Myopathies are sometimes induced by hypoparathyroidism. An association between systemic lupus erythematosus and hypoparathyroidism seems to exist.
Topics: Humans; Parathyroid Diseases; Rheumatic Diseases
PubMed: 21989974
DOI: 10.1007/s00393-011-0796-4 -
Otolaryngologic Clinics of North America Aug 1996Radionuclide scanning for hyperparathyroidism is an accurate cost-effective preoperative test that can provide the basis for more effective surgery.
Radionuclide scanning for hyperparathyroidism is an accurate cost-effective preoperative test that can provide the basis for more effective surgery.
Topics: Adenoma; Humans; Parathyroid Diseases; Parathyroid Glands; Parathyroid Neoplasms; Parathyroidectomy; Preoperative Care; Radionuclide Imaging; Technetium; Thallium; Thyroid Diseases
PubMed: 8844737
DOI: No ID Found -
Annali Italiani Di Chirurgia 2001Parathyroid cysts are rare, representing 1% of all neck swellings. A correct preoperative diagnosis is rarely formulated, especially because of the non-specific clinical... (Review)
Review
Parathyroid cysts are rare, representing 1% of all neck swellings. A correct preoperative diagnosis is rarely formulated, especially because of the non-specific clinical and ultrasonographic findings; for this reason, patients are often submitted to surgery for thyroid nodules. In the present report we describe a case where the preoperative diagnosis was correctly formulated following the aspiration and PTH assay of clear, colorless, watery fluid from the cyst. While cyst aspiration is considered the elective treatment for these lesions, recurrences being uncommon, surgery was indicated in the present case because of two recurrences after aspiration and the onset of compressive symptoms. Cystic masses of the neck should be accurately diagnosed to recognize their true nature and to allow their correct and non-invasive treatment: surgery is indicated only when recurrences and symptoms are present. Indications for aspiration of all solitary cysts of the neck should be considered to correctly identify their nature.
Topics: Adult; Cysts; Female; Humans; Parathyroid Diseases
PubMed: 11765353
DOI: No ID Found -
Annali Italiani Di Chirurgia 2021Parathyroid carcinoma (PC) represents a rare cause of primary hyperparathyroidism (PHPT). In this paper, among patients who underwent surgery for PHPT, we compared those... (Review)
Review
AIM
Parathyroid carcinoma (PC) represents a rare cause of primary hyperparathyroidism (PHPT). In this paper, among patients who underwent surgery for PHPT, we compared those with benign parathyroid disease with those affected by PC in terms of demographic and preoperative biochemical features. Moreover, we singularly described all 10 cases of PC treated at our Institution (including a case that occurred in a patient with tertiary hyperparathyroidism) and a brief review of the literature.
MATERIAL AND METHODS
Patients undergoing surgery for PHPT in our Unit between 2003 and 2018 were retrospectively analysed. They were divided into two groups: Group A (benign parathyroid disease), Group B (PC). The case of PC that occurred in the patient with tertiary hyperparathyroidism was not included into the two groups.
RESULTS
Three hundred and eight patients were included: 299 in Group A and 9 in Group B. The mean preoperative serum PTH value and mean preoperative serum calcium level were significantly higher in Group B than in Group A (P = 0.018, P = 0.027; respectively). Including the case of PC that occurred in the patient with tertiary hyperparathyroidism, 10 patients with PC were treated at our Institution. Among these, 3 underwent a re-exploration. Disease recurrence occurred in 1 (10%) patient, who developed a local recurrence and distant metastases.
CONCLUSIONS
In the presence of PHPT characterized by particularly high preoperative levels of serum PTH and calcium this malignancy should be suspected. On the basis of our experience, we believe that extensive surgery is not always necessary.
KEY WORDS
Hyperparathyroidism, Parathyroid carcinoma, Parathyroid surgery.
Topics: Calcium; Humans; Hyperparathyroidism, Primary; Neoplasm Recurrence, Local; Parathyroid Diseases; Parathyroid Hormone; Parathyroid Neoplasms; Parathyroidectomy; Reoperation; Retrospective Studies
PubMed: 34312331
DOI: No ID Found -
Nephrology, Dialysis, Transplantation :... Jun 2003The first choice for imaging diagnosis of parathyroid gland (PTG) abnormalities is ultrasonography with a high-frequency probe. The patient must be positioned correctly... (Review)
Review
The first choice for imaging diagnosis of parathyroid gland (PTG) abnormalities is ultrasonography with a high-frequency probe. The patient must be positioned correctly when performing either imaging or percutaneous ethanol injection (PEIT) of the PTG. The enlarged PTGs are examined by ultrasonic tomography using 3D measurements, and it is important to evaluate blood flow; the PTGs are hypervascular in comparison with a nodular lesion of the thyroid. Based on the 3D data, the estimated volume of the gland is calculated (a x b x c x pi/6), from which the volume of ethanol to be injected is determined. The operator performing the puncture should be skilled in interventional ultrasonography, including needle biopsy of superficial organs, because when the PTG enlargement is advanced, ethanol must be injected in several steps while checking for residual blood flow. After locating the tip of the needle by ultrasonography, the ethanol is injected, the jet echoes that spread from the tip of the needle are confirmed, and when there is no leakage from the gland, a volume of ethanol corresponding to approximately 50% of the volume of the enlarged gland is injected. If residual blood flow is observed, additional ethanol is injected at the site. After completion of PEIT of the PTG, colour Doppler imaging is repeated and, if there is no blood flow, then the procedure is considered to be successful.
Topics: Ethanol; Humans; Imaging, Three-Dimensional; Injections, Intralesional; Parathyroid Diseases; Parathyroid Glands; Ultrasonography, Doppler, Color
PubMed: 12771295
DOI: 10.1093/ndt/gfg1007 -
Hormones (Athens, Greece) 2012Parathyroid cysts (PC) are uncommon entities in routine clinical practice. The vast majority are nonfunctioning and are commonly present as asymptomatic nodular cervical... (Review)
Review
BACKGROUND
Parathyroid cysts (PC) are uncommon entities in routine clinical practice. The vast majority are nonfunctioning and are commonly present as asymptomatic nodular cervical lesions. PC should be considered in the differential diagnosis of an asymptomatic neck mass. Large PC can manifest with compressive symptoms of the surrounding tissues.
OBJECTIVE
The aim of this study is to describe nine new cases of PC and review the current literature regarding the clinical presentation, the aetiopathology, the diagnostic procedures, as well as the therapeutic approaches for this relatively rare clinical entity. METHODS-PATIENTS: We present nine new patients (7 females and 2 males) diagnosed with PC, which in three were ectopic. The diagnosis of PC was based on the elevated levels of PTH in the cysts fluid. Six of the patients had nonfunctioning parathyroid lesions, while the other three had functioning ones. Patients with functioning PC had elevated serum calcium and PTH levels. Five out of nine of the cases had no symptoms, while two patients had compressive symptoms and the other two had signs and symptoms of hypercalcaemia. Needle aspiration (NA) was performed in five out of six patients with nonfunctioning PC. Surgery was the treatment in all three patients with functioning PC.
RESULTS
Remission after NA was achieved in four out of five patients with non-functioning PC (follow-up time: 17.7±2.3 months). In two of them, two and three aspirations were needed. One patient with nonfunctioning PC submitted to surgery with no previous NA. Patients with functioning PC maintained remission after surgery (mean follow-up time: 22.1±2.9 months). In one of them, a second surgery was performed due to the co-existence of an ectopic parathyroid adenoma.
CONCLUSIONS
The diagnosis of a PC can be established by finding high levels of PTH in the fluid collected by the aspiration of the cyst. PTH and Ca levels in the serum can differentiate functioning from nonfunctioning PC. The treatment of choice in nonfunctioning cysts is aspiration. Surgical removal of the cyst is indicated in hyperfunctioning cysts in cases of relapse after NA in nonfunctioning cysts and when compressive symptoms are present. Based on our series, which appears to be one of the largest reported, we propose a diagnostic algorithm to guide the diagnostic and therapeutic approach to PC.
Topics: Adenoma; Adult; Aged, 80 and over; Algorithms; Biopsy, Needle; Cysts; Female; Humans; Hypercalcemia; Male; Middle Aged; Parathyroid Diseases; Parathyroid Glands; Parathyroid Hormone; Parathyroid Neoplasms
PubMed: 23422763
DOI: 10.14310/horm.2002.1372