Osteitis Fibrosa Cystica Simulating Metastatic Tumor:<i>An Almost-Forgotten Relationship</i>

Bassler, Thomas J.; Wong, Edward T.; Brynes, Russell K.

doi:10.1093/ajcp/100.6.697

Cited by 46 publications

(33 citation statements)

References 0 publications

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“…Superior glands in general migrate minimally caudally towards the dorsal surface of the thyroid gland. Inferior glands in general migrate caudally and medially and thus can be localized anywhere between the pericardium and jaw [12,13]. Ectopic parathyroid adenomas are predominantly located in the thymus (38%), followed by the retro-oesophageal region (31%) and intrathyroidal (18%) [14].…”

Section: Discussionmentioning

confidence: 99%

A Parathyroid Adenoma Dorsal of the Esophagus, An Ectopic Localization

Rr¹,

Ka²,

Pc³

2017

Med Case Rep

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A 65-year-old female was analyzed because of obstipation and hypercalcaemia, which was the result of primary hyperparathyroidism. The parathyroid adenoma was ectopically located. Initial physical examination was performed, followed by subsequent laboratory and ultrasound examination, tc-99m sestamibi scintigraphy and computed tomography. It revealed a parathyroid gland with an ectopic localization dorsally of the esophagus. The ectopic parathyroid adenoma was surgically removed, and her complaints disappeared.

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Section: Discussionmentioning

confidence: 99%

A Parathyroid Adenoma Dorsal of the Esophagus, An Ectopic Localization

Rr¹,

Ka²,

Pc³

2017

Med Case Rep

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“…The thymus then migrates caudally and medially, pulling the parathyroid glands with it. And therefore they can be found anywhere between the jaw and the pericardium10 (figure 3).

Learning points

Less than 0.1% of the inferior parathyroid glands are ectopically located.

Thorough assessment of a CT-scan in combination with clinical data leading to the suspicion of an ectopic parathyroid adenoma is of paramount importance.

Localisation even at the level of the hyoid bone is possible for a parathyroid adenoma.

…”

Section: Discussionmentioning

confidence: 99%

“…This wide variety of physical symptoms makes it difficult to follow purely on clinical judgement. Biochemical and medical imaging are of paramount importance in this diagnosis 1. High PTH and calcium levels can be determined in blood diagnostics.…”

Section: Investigationsmentioning

confidence: 99%

Exceptional localisation of an ectopic parathyroid adenoma at the level of the hyoid bone

2014

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Primary hyperparathyroidism is characterised by high parathyroid hormone (PTH) levels and concomitant hypercalcaemia. Ninety per cent is caused by solitary parathyroid adenomas, 10% by multiple adenomas, hyperplasia and carcinomas. Less than 0.1% of the inferior parathyroid glands are ectopically located. This case is of a 54-year-old woman with hypercalcaemia 3.05 mmol/L and high PTH 22 pmol/L. Scintigraphy and CT scan of the neck in 2009 showed no signs of ectopic tissue. After treatment with Aredia (pamidronate disodium) infusion, calcium decreased to 2.73 mmol/L. In 2010 the serum calcium levels increased again to 3 mmol/L. Repeated CT showed no ectopic tissue. However, revision of the CT by the multidisciplinary team including an experienced endocrine surgeon revealed an ectopic parathyroid gland at the level of the hyoid bone, which was surgically removed in 2011. Preoperatively the PTH level was 16.8 mmol/L, postoperatively it decreased to 2.9 mmol/L, proving a successful excision. In case of suspicion of a parathyroid adenoma a CT of the neck should be thoroughly assessed by a dedicated multidisciplinary team, including the head and neck surgeon, as clinical data and radiological findings must be combined since ectopic parathyroid adenomas are a rare entity. Thereafter the adenoma can be surgically removed and the patient cured.

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“…A consistently high corrected serum calcium, raised serum chloride, normal or moderately raised alkaline phosphatase and raised serum intact PTH are diagnostic biochemical criteria that differentiate PHPT from hypercalcaemia of malignancy [2]. Raised intact PTH is the most important and consistent finding in PHPT [9].…”

Section: Discussionmentioning

confidence: 99%