Background Accurate preoperative radiological localization of parathyroid pathologies paves the way to enable less invasive surgical procedures. Results on the accuracy of the different diagnostic measures are conflicting. Also, little is known about the most common location of parathyroid lesions. This paper aims to determine the most common location of parathyroid adenoma and evaluate the diagnostic performance of radiological modalities such as ultrasonography, sestamibi scintigraphy/single-photon emission computerized tomography (SPECT), magnetic resonance imaging (MRI), and computed tomography (CT) scan for the preoperative localization of parathyroid pathologies. Methods This is a retrospective study. Data were collected from patients who underwent total or partial parathyroidectomy at King Abdulaziz University Hospital between January 2000 and March 2020. The parathyroid adenoma site was detected preoperatively by a radiological method and confirmed postoperatively by the histopathology report. The performance of each preoperative localizing radiological method was evaluated based on the accuracy in localizing parathyroid pathology. Results A total of 73 patients were included in the analysis, with females being the most common gender in the study at 64%. Only complete data files were included and incomplete data files were excluded. The most frequent mode of detecting parathyroid adenoma was a sestamibi/SPECT scan (62.5%) followed by a CT scan (50%), ultrasound (34.6%), and MRI (25%). The most common location of a parathyroid adenoma was the left side. Conclusion Sestamibi/SPECT is a frequent radiological method for detecting the parathyroid lesion site as compared with CT, MRI, and ultrasonography.
Nodular fasciitis (NF) is a rare benign self-limiting lesion that is often mistaken for malignancy due to its progressive nature. Reported cases of nodular fasciitis in the parotid gland are uncommon, and its incidence is variable among different age groups. Histopathological and immunohistochemical studies are helpful in distinguishing these kinds of lesions. We report a case of a six-month-old baby with a two-month history of progressive rapid-growing mass in the left parotid region. Clinical examination showed some mild facial nerve weakness with no other significant findings locally or systemically. Fine-needle aspiration (FNA) was inconclusive, and surgical excision was the choice of treatment. On histological examination, the mass was confirmed to be nodular fasciitis, and on follow-up, the patient had no signs of recurrence. Nodular fasciitis can appear in young infants and, if confirmed histopathologically and immunohistochemically, should be treated conservatively.
Renal transplantation is the best management for patients suffering from end-stage renal disease (ESRD). It has many benefits which overcome the complications of dialysis, it has some acute and long term complications that could result in failure. Failure of transplant is the fourth cause of death among patients with end stage kidney disease. The causes of failure is still a debate but rejection, drug toxicity and fibrosis as well as chronic allograft nephropathy and patient's immunity related factors. This review will provide important information regarding the causes associated with post-renal transplant failure.
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