No abstract

1. MEN syndrome is a rare cause of primary hyperparathyroidism. 2. Subtotal parathyroidectomy helps to bring back a normal calcium metabolism. 3. Recurrence of hyperparathyroidism in patients with MEN syndrome requires total parathyroidectomy with an autotransplantation into the anterior forearm muscles.

Introduction: It is difficult to differentiate benign and malignant lesions just by histopathological evaluation due to lack of clear criteria of diagnosis. Moreover, the group of benign pathologies of parathyroids is not homogenous, and recurrence of symptoms of hyperparathyroidism after surgical management was also noted in this group. This complication is not always due to inappropriate surgical technique. The goal of this work was to find the relationship between cellular ploidy and proliferative activity of adenomas and hyperplasia of parathyroids and preoperative levels of calcium and parathormone in the serum of patients surgically treated for primary hyperparathyroidism. Material and methods: A total of 98 parathyroid glands were tested, of which 81 (82.7%) were from female patients and 17 (17.3%) from male; the age of the patients was from 22 to 82 years, with an average of 58 years. Results: In resected glands pathological evaluation showed the following results: in 53 (54.1%) adenoma was present, and in 45 (45.9%) there was hyperplasia. Sixty-seven of the samples (68.4%) were characterised as diploid and 31 (31.6%) as aneuploid. There is important positive correlation (r = 0.34595; p = 0.011) between the percentage of S-phase cells (% SPF) and calcium levels measured prior to surgical resection of adenoma. The further analysis of patients with adenoma characterised by aneuploidy proved a statistically valid, positive correlation between %SPF and ionised calcium levels in blood serum of patients both before (r = 0.7189; p = 0.003) and after the surgical treatment (r = 0.6313; p = 0.012). Conclusions: 1. Benign lesions of parathyroid with ploidy indicates their heterogeneity. 2. In aneuploid benign adenomas of parathyroid glands an increased percentage of cells in S phase (% SPF) correlates with a high level of calcium in serum pre-and post-parathyroidectomy.

Background: Primary hyperparathyroidism (PHPT) is one of the most common endocrine disorders and defined as excessive secretion of parathormone. PHPT is a risk factor of several cardiovascular diseases, which could be caused by alterations in oxidant-antioxidant balance. Materials and methods: Blood serum collected from 52 consecutive patients with PHPT treated surgically constituted our study material, whereas 36 healthy volunteers were our control group. Oxidative stress was evaluated in both patients and control subjects by assessment of malondialdehyde (MDA) and lipid hydroperoxides (LHP). Antioxidants were evaluated by the measurement of superoxide dismutase (SOD), ceruloplasmin (CER), catalase (CAT), sulfhydryl (SH) groups, glutathione (GSH), glutathione peroxidase (GSH-Px), glutathione transferase activity (GST) and glutathione reductase (GR). Moreover total antioxidant capacity (TAC) and total oxidative status (TOS) were measured and oxidative stress index (OSI) was calculated. Results: OSI was increased in patients with PHPT when compared to normal controls, whereas TAC was lower in PHPT. The levels of CER, MnSOD, GR, SH groups and MDA were significantly decreased in PHPT. The levels of serum LHP, catalase and SOD were significantly higher in patients with PHPT than in healthy patients. The erythrocyte CAT activity and GST were significantly increased in patients after parathyroidectomy. The erythrocyte GR and GPx were up-regulated postoperatively, whereas SOD activity decreased. Conclusions: In PHPT there are several alterations in the balance between the production of reactive oxygen species and antioxidant defense system.

Backround. Small bowel cancers account for less than 0.5% of all malignancies and approximately 1-3% of gastrointestinal tract malignancies. The two major tumour types are carcinoid and adenocarcinoma. The latter is most commonly found in the duodenum and jejunum, but least often in the ileum. Case presentation. We present a case study of a 67-year-old woman with small bowel adenocarcinoma (SBA) of the ileum. The patient was admitted to the hospital with nonspecific, persistent, recurrent pain in her upper abdomen and with suspected subileus. Previously performed clinical investigation (i.e. colonoscopy, computed tomography scans -CT scans, small bowel follow-through) didn't reveal any abnormalities. At laparotomy we discovered a round mass obstructing the ileal lumen at about 40 cm from the Bauhin valve. A tumour was then resected within its surgical margins. Pathologic examination revealed an ileal adenocarcinoma and an infiltration of the local adipose tissue (Adenocarcinoma G3 partim gelatinosum), with no evidence of metastatic lesions in the lymph nodes nor into other organs (pT3N0M0; the clinical stage IIA). Further oncological treatment was thereby advised. Conclusions. A low prevalence and non-specific symptoms along without any clearly established diagnostic nor treatment protocols makes a final diagnosis difficult and thus merits further diagnostic investigation, particularly the testing of specific biochemical or immunological markers. NOWOTWORY J Oncol 2017; 67, 2: 137-141