Preoperative ultrasonographic diagnosis of a parathyroid adenoma in a child

Rodríguez-Cueto, G; Manzano-Sierra, C.; Villalpando, Salvador

doi:10.1007/bf02386732

Cited by 2 publications

(1 citation statement)

References 5 publications

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“…Imaging techniques emerged in the 1980s, and in 1984 Rodriguez-Cueto et al [7] used ultrasonography for the first time to identify a parathyroid adenoma preoperatively in a 15-year-old adolescent.…”

Section: Discussionmentioning

confidence: 99%

Primary Hyperparathyroidism in Neonates and Childhood

Mallet¹

2008

Horm Res Paediatr

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Objectives: Primary hyperparathyroidism (HP1) in childhood is thought to be extremely rare. Its exact incidence remains unknown, as do the characteristics of HP1. A retrospective study collection was conducted on cases supplied by members of the Working Group on Calcium Metabolism throughout France over a 20-year period (1984–2004), since the availability of the intact parathormone (iPTH) radioimmunoassay. Results: 55 cases were collected of which 11 were neonates. Among the 44 children and adolescents, there were 18 male and 26 female patients, ranging in age from 6 to 18 (mean 13) years. 83% were symptomatic and 43% had nephrolithiasis. Symptoms were associated with high serum calcium and inappropriate iPTH levels. Ultrasonography and technetium-labelled methoxyisobutylisonitrile scintigraphy are useful tools for the preoperative localization of adenomas, particularly in adolescents. Intraoperative iPTH assays are effective in minimizing invasive parathyroidectomy. All patients, except neonates, underwent surgery: 29 adenomas and 11 hyperplasias were found. Two multiple endocrine neoplasias (MENs) were subsequently discovered. Since the calcium-sensing receptor (CaSR) mutation was reported, the form of management in neonates has become more medical (intravenous diphosphonates) than surgical. On follow-up no recurrence was observed except for MEN. Conclusion: These national results reflect HP1 epidemiology. HP1 is a rare entity and appears to be a severe disease in terms of symptoms with regard to management. The use of molecular biology tests could be useful not only in neonatal cases (CaSR mutation) but also prior to surgery in children (MEN mutation).

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Section: Discussionmentioning

confidence: 99%

Primary Hyperparathyroidism in Neonates and Childhood

Mallet¹

2008

Horm Res Paediatr

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Primary hyperparathyroidism in a paediatric hospital

Lawson¹,

Miller²,

Ellis³

et al. 1996

QJM

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We retrospectively reviewed the presentation and management of children with primary hyperparathyroidism (PHPT) from 1973 to 1995 at a paediatric tertiary-care centre. There were 11 patients (6 females), aged 12.3-17.7 years at presentation, with sporadic PHPT confirmed by histopathology (single adenoma). Presentation consisted of renal colic, or non-specific gastrointestinal, musculoskeletal or neurological symptoms. Misdiagnosis was common until hypercalcaemia was identified, 0.5-24 months after onset of symptoms (mean 7.7 months). All patients had hypercalcaemia and low-normal serum phosphate. The parathyroid hormone (PTH) radioimmunoassay used before 1986 was elevated in 1/4 patients; the intact PTH assay used after 1986 was elevated in 7/7 patients. At presentation, six had end-organ damage: band keratopathy, renal lesions, and/or bone disease. Preoperative localization was accurate in 0/4 patients diagnosed before 1986, but 5/7 patients diagnosed after 1986: three by ultrasound or sestamibi scan alone, and two by ultrasound and technetium scan. Surgical outcome was not dependent upon the accuracy of pre-operative localization. PHPT is rare in children but usually associated with end-organ damage, presumably due to delayed diagnosis. It should be considered in the differential diagnosis of unexplained non-specific complaints. The intact PTH assay greatly assists pre-operative diagnosis. The usefulness of pre-operative localization requires further research.

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Preoperative ultrasonographic diagnosis of a parathyroid adenoma in a child

Cited by 2 publications

References 5 publications

Primary Hyperparathyroidism in Neonates and Childhood

Primary Hyperparathyroidism in Neonates and Childhood

Primary hyperparathyroidism in a paediatric hospital

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