A Parathyroid Adenoma: Benign Disease Presenting with Hyperparathyroid Crisis

Tahim, A. S.; Saunders, John Adamson; Sinha, Prakash

doi:10.1155/2010/596185

Cited by 4 publications

(4 citation statements)

References 18 publications

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“…(1) Currently, t he primar y me t ho d of t reat ment is parathyroidectomy. (2,3) This method of treatment, however, may not be possible when there is a high surgical risk or contraindication for surgery, or when the patient is reticent to undergo surgical procedures. The latter being a concern raised mainly by women due to the possibility of a resulting postoperative scar.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous sonography-guided radiofrequency ablation in the management of parathyroid adenoma

Xu¹,

Ya²,

Xie³

et al. 2013

smedj

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C a s e R e p o r t e137 I NTRO D U C TIO NParathyroid adenoma is a major cause of primary hyperparathyroidism, with an incidence of 80%-85%.(1) Currently, t he primar y me t ho d of t reat ment is parathyroidectomy. (2,3) This method of treatment, however, may not be possible when there is a high surgical risk or contraindication for surgery, or when the patient is reticent to undergo surgical procedures. The latter being a concern raised mainly by women due to the possibility of a resulting postoperative scar. Hence, in most cases, parathyroidectomy is only performed on selected patients.With the swift development of minimally invasive and highly specific techniques, percutaneous sonography-guided radiofrequency ablation (RFA) therapy has been steadily progressing and yielding good clinical results.(4-7) While RFA has been used as a reasonably effective method to treat some primary and secondary tumours of the thyroid,lung (5,6) and liver, (7) the procedure is not limited to these organs. This report describes our experience with RFA in the treatment of parathyroid adenoma, and aims to assess the safety, effectiveness and durability of this procedure for the treatment of parathyroid adenoma. CA S E R EPO RT S Case 1A 50-year-old man presented to our hospital with a onemonth history of vomiting, general fatigue and bone pain. ABSTRACT Parathyroid adenoma is a major cause of primary hyperparathyroidism. Treatment usually involves the surgical removal of one or more parathyroid glands. However, specific localising techniques have boosted the development of nonsurgical, minimally invasive procedures, such as percutaneous radiofrequency ablation (RFA) under ultrasonographic guidance, which are gaining popularity as a method of treatment. This paper reports two male patients who presented with hypercalcaemia (highest serum calcium level 4.56 mmol/L and 4.57 mmol/L, respectively) and hyperparathyroidism (highest serum parathyroid hormone [PTH] level 772 ng/L and > 1,900 ng/L, respectively) due to solitary parathyroid adenoma. Four days after percutaneous RFA, the serum calcium levels in both patients decreased and PTH levels showed a significant decreasing trend. Both patients recovered well with normal levels of calcium and improvement of symptoms. Thus, we conclude that RFA may be a safe and effective therapeutic option in the treatment of parathyroid adenoma. Keywords: hypercalcaemia, intervention, parathyroid adenoma, radiofrequency ablationSingapore Med J 2013; 54(7): e137-e140 doi: 10.11622/smedj.2013092 Tc-sestamibi scintigraphy images before radiofrequency ablation show increased uptake of the radionuclide in the middle right lobe of the thyroid gland.

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Section: Introductionmentioning

confidence: 99%

Percutaneous sonography-guided radiofrequency ablation in the management of parathyroid adenoma

Xu¹,

Ya²,

Xie³

et al. 2013

smedj

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“…Primar y hyperparathyroidism is a rare disease with hyperparathyroid crisis being an unusual presentation. 11,14 Increased levels of parathyroid hormones are seen more with malignant lesions. Intrathyroid parathyroid adenomas are extremely rare tumors.…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of a Giant Congenital Multinodular Goiter with Intrathyroidal Parathyroid Adenoma

Menon¹,

M²

2020

International Journal of Head and Neck Surgery

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Aim: To highlight the management of huge multinodular goiters and report a rare case of intrathyroidal parathyroid adenoma. Background: Goiter is an abnormal enlargement of thyroid gland. Huge goiters are a surgical challenge due to possible difficulty in intubation, tracheomalacia, retrosternal extension and distorted anatomy. Goiters associated with congenital hypothyroidism undetected at birth leads to permanent neurological deficits. This case report highlights a case of huge multinodular goiter with a rare intrathyroidal parathyroid adenoma detected on histopathology. Case description: This case report deals with a 27-year-old male patient, presenting with huge hypothyroid multinodular goiter weighing 750 g with no compression symptoms. He had low IQ probably due to undetected hypothyroidism at birth. His postoperative histopathology report showed an intrathyroidal parathyroid adenoma which is an extremely rare tumor. Conclusion:This report aims to emphasize the existence of congenital hypothyroidism and also that huge goiters when dissected meticulously may be removed without any major complications. We also report an incidental finding of rare intrathyroidal parathyroid adenoma. Clinical significance: Neonatal screening of hypothyroidism and its subsequent treatment can prevent mental retardation. We would also like to emphasize the importance of preoperative serum parathormone and calcium levels in all patients undergoing thyroidectomy to detect asymptomatic parathyroid adenomas.

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“…Hyperparathyroid crisis is a rare condition, where patients present with lethargy, weakness, vomiting, abdominal pain and confusion. It is an endocrine emergency which requires rapid correction of dehydration and hypercalcaemia followed by surgical resection of diseased parathyroid glands [2].…”

Section: Discussionmentioning

confidence: 99%

“…reported in the literature [2]. Therefore intra operative assessment of the enlarged parathyroid gland is necessary to differentiate benign from malignant enlargement as malignant lesion will need a more radical procedures.…”

Section: Intraoperative Localization Of Parathyroid Adenoma Utilizingmentioning

confidence: 99%

Intraoperative localization of parathyroid adenoma utilizing intravenous methylene blue

Vaseethan

Raviraj

2017

Sri Lanka j Surg

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A Parathyroid Adenoma: Benign Disease Presenting with Hyperparathyroid Crisis

Cited by 4 publications

References 18 publications

Percutaneous sonography-guided radiofrequency ablation in the management of parathyroid adenoma

Percutaneous sonography-guided radiofrequency ablation in the management of parathyroid adenoma

A Rare Case of a Giant Congenital Multinodular Goiter with Intrathyroidal Parathyroid Adenoma

Intraoperative localization of parathyroid adenoma utilizing intravenous methylene blue

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