Differentiation of parathyroid carcinoma and adenoma by preoperative ultrasonography

Nam, Myung Hyun; Jeong, Hyun‐Dam; Shin, Jung Hee

doi:10.1177/0284185116666418

Cited by 35 publications

(37 citation statements)

References 21 publications

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“…As expected, a low serum phosphate level was not uncommon and was found in eight (29%) of our patients [19]. Adenoma size was similar to that reported in other studies in non-SCD patients (14.4 mm vs. 19 mm in a recent study including 32 patients with parathyroid adenomas [20]).…”

Section: General Considerationssupporting

confidence: 91%

Primary Hyperparathyroidism in Sickle Cell Disease: An Unknown Complication of the Disease in Adulthood

Denoix

Bomahou

Clavier

et al. 2020

JCM

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Primary hyperparathyroidism (pHPT) is the third most common endocrine disorder and usually affects patients between 60 and 70 years of age. To our knowledge, this condition has never been studied in young patients with sickle cell disease (SCD). Our objective was to describe the clinical and biological characteristics of pHPT in adult patients with SCD and its management. We conducted a retrospective study that included SCD patients who were diagnosed with pHPT in four SCD referral centers. pHPT was defined by the presence of elevated serum calcium levels with inappropriate normal or increased parathyroid hormone (PTH) serum levels or histopathological evidence of parathyroid adenoma or hyperplasia. Patients with severe renal impairment (GFR <30 mL/min) were excluded. Twenty-eight patients (18 women, 64%; 22 homozygous genotype, 79%) were included. The median age at pHPT diagnosis was 41 years (interquartile range –IQR- 31.5–49.5). The median serum calcium and PTH concentration were, respectively, 2.62 mmol/L (IQR 2.60–2.78) and 105 pg/mL (IQR 69–137). Bone mineral density (BMD) revealed very low BMD (≤−2.5 SD) in 44% of patients explored (vs. 12.5% among 32 SCD patients matched for SCD genotype, sex, age, and BMI, p = 0.03). Fourteen patients (50%) received surgical treatment, which was successful in all cases, but four of these patients (29%) presented with pHPT recurrence after a median time of 6.5 years. Three of these patients underwent a second cervical surgery that confirmed the presence of a new parathyroid adenoma. These results suggest that SCD is a condition associated with pHPT in young subjects. SCD patients with pHPT have a high risk of very low BMD. A diagnosis of pHPT should be suspected in the presence of mild hypercalcemia or low BMD in SCD patients.

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Section: General Considerationssupporting

confidence: 91%

Primary Hyperparathyroidism in Sickle Cell Disease: An Unknown Complication of the Disease in Adulthood

Denoix

Bomahou

Clavier

et al. 2020

JCM

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“…In cases of giant parathyroid adenoma, differentiation from parathyroid carcinoma is necessary. Parathyroid carcinoma is often accompanied by osseous symptoms [3] and shows as a palpable mass [4,5]. Our case also exhibited these clinical ndings; however, the ndings of image studies in our case were incompatible with carcinoma.…”

Section: Discussionsupporting

confidence: 47%

“…Our case also exhibited these clinical ndings; however, the ndings of image studies in our case were incompatible with carcinoma. Our tumor was an oval-shaped mass with a well-circumscribed margin and separation from surrounding tissue [5]. The depth/width ratio was 0.96, which represents adenoma, rather than carcinoma [6].…”

Section: Discussionmentioning

confidence: 84%

A Case Report of A Giant Parathyroid Adenoma Presenting with A Brown Tumor

Enomoto

Fukumoto

Osaka

et al. 2020

Preprint

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Abstract Background: Giant parathyroid adenoma presenting with a brown tumor is considered extremely rare.Case Presentation: A 21-year-old woman presented to the clinic with persistent pain in her right knee. A radiographic examination showed an osteolytic lesion in her right tibia. Blood laboratory tests revealed that serum calcium and intact parathyroid hormone were increased significantly. Physical examination showed a 3-cm, firm, immovable lump in her neck. Ultrasonography of the patient’s neck revealed a 3.5-cm, well-circumscribed mass with a homogeneous internal texture. Computed tomography also showed a localized tumor with clear margins. The 99mTc-MIBI scintigraphy showed a hot spot in the right inferior gland. Based on these findings we judged that she had giant parathyroid adenoma presenting with a brown tumor. We ruled out the possibility of carcinoma based on image studies. We performed a parathyroidectomy via a small incision. The excised parathyroid gland weighed 10.3 g. The patient’s postoperative course was unremarkable. Conclusions: Giant parathyroid adenoma presenting with a brown tumor is extremely rare. Accordingly, the differentiation between giant adenoma and parathyroid carcinoma is crucial. However, we could rule out the possibility of carcinoma based on imaging studies, including ultrasonography and computed tomography. As a result, we performed successful parathyroidectomy with a small incision.

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“…Подозрительны в этом отношении: крупные размеры (3 см и более), неоднородная структура, неправильная форма (неровные края), признаки местной инвазии, чрезвычайно интенсивная васкуляризация образования (рис. 4) [33].…”

Section: диагностикаunclassified

Imaging methods of the parathyroid glands in primary hyperparathyroidism. Literature review

Slashchuk¹,

Degtyarev²,

Rumyantsev³

et al. 2020

Endo Serg

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Primary hyperparathyroidism (PHPT) is a common endocrine disease that occurs with multiple profiles in which no classical manifestation. Diagnosis revolves around routine measurement of serum calcium and parathyroid hormone more than in half cases. The understanding of clinical presentation, epidemiology and management tactics of patients with hyperparathyroidism has significantly changed by virtue of the use of biochemical calcium screening. The successful diagnosis and treatment are possible with the cooperation of a multidisciplinary team of endocrinologist, endocrine surgeon, radiologist, nuclear medicine physician and pathomorphologist. The only radical method of treatment is the surgical removal of abnormal parathyroid glands. In this regard, there is necessary to improve the parathyroid glands imaging algorithms. Early treatment of hyperparathyroidism allows to avoid severe damage to the bones, kidneys, heart, other organs, improving the quality of life and reducing the incidence of disability. For a systematic literature review, more than 100 articles published from 2000 to the present time were used, on following resources: PubMed, Embase, SciSearch, Scopus, Cochrane Databases, Research Gate, Google Scholar. Including recommendations from the American Association of Endocrinologists and Endocrine Surgeons (AACE/AAES), European Society of Nuclear Medicine (EANM), European Society ofEndocrinologists (ESE), Russian Association of Endocrinologists (RAE) and several other organizations. The main goal of this review is to summarize and present relevant information and a new look on preoperative imaging techniques, methods of intraoperative navigation, surgery, control quality of treatment in patients with primary hyperparathyroidism.

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Differentiation of parathyroid carcinoma and adenoma by preoperative ultrasonography

Cited by 35 publications

References 21 publications

Primary Hyperparathyroidism in Sickle Cell Disease: An Unknown Complication of the Disease in Adulthood

Primary Hyperparathyroidism in Sickle Cell Disease: An Unknown Complication of the Disease in Adulthood

A Case Report of A Giant Parathyroid Adenoma Presenting with A Brown Tumor

Imaging methods of the parathyroid glands in primary hyperparathyroidism. Literature review

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