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1. Barczyński M, Cichoń S, Konturek A, Cichoń W: Minimally invasive video-assisted parathyroidectomy versus open minimally invasive parathyroidectomy for a solitary parathyroid adenoma: a prospective, randomized, blinded trial. World J Surg; 2006 May;30(5):721-31
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Minimally invasive video-assisted parathyroidectomy versus open minimally invasive parathyroidectomy for a solitary parathyroid adenoma: a prospective, randomized, blinded trial.
  • BACKGROUND: A variety of minimally invasive parathyroidectomy (MIP) techniques have been currently introduced to surgical management of primary hyperparathyroidism (pHPT) caused by a solitary parathyroid adenoma.
  • MATERIALS AND METHODS: Among 84 consecutive pHPT patients referred for surgery, 60 individuals with concordant localization of parathyroid adenoma on ultrasound and subtraction Tc99m-MIBI scintigraphy were found eligible for MIP under general anesthesia and were randomized to two groups (n = 30 each): MIVAP and OMIP.
  • An intraoperative intact parathyroid hormone (iPTH) assay was routinely used in both groups to determine the cure.
  • Primary end-points were the success rate in achieving the cure from hyperparathyroid state and hypocalcemia rate.
  • In 2 patients, an intraoperative iPTH assay revealed a need for further exploration: in one MIVAP patient, subtotal parathyroidectomy for parathyroid hyperplasia was performed with the video-assisted approach, and in an OMIP patient, the approach was converted to unilateral neck exploration with the final diagnosis of double adenoma.
  • CONCLUSIONS: Both MIVAP and OMIP offer a valuable approach for solitary parathyroid adenoma with a similar excellent success rate and a minimal morbidity rate.
  • [MeSH-major] Adenoma / surgery. Parathyroid Neoplasms / surgery. Parathyroidectomy

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  • (PMID = 16547619.001).
  • [ISSN] 0364-2313
  • [Journal-full-title] World journal of surgery
  • [ISO-abbreviation] World J Surg
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Randomized Controlled Trial
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Analgesics
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2. Alexandrides TK, Kouloubi K, Vagenakis AG, Yarmenitis S, Spyridonidis T, Vassilakos P, Apostolopoulos D: The value of scintigraphy and ultrasonography in the preoperative localization of parathyroid glands in patients with primary hyperparathyroidism and concomitant thyroid disease. Hormones (Athens); 2006 Jan-Mar;5(1):42-51
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The value of scintigraphy and ultrasonography in the preoperative localization of parathyroid glands in patients with primary hyperparathyroidism and concomitant thyroid disease.
  • Parathyroid scintigraphy and high-resolution ultrasonography are frequently used as preoperative localization procedures in primary hyperparathyroidism.
  • DESIGN: 56 patients with primary hyperparathyroidism were prospectively evaluated with parathyroid scintigraphy (with either thallium or technetium-99m agents or both) and 44 of them were also evaluated with ultrasonography.
  • Upon operation, 48 patients were found to have a solitary parathyroid adenoma and were all cured.
  • One patient had a carcinoma and 7 had multiglandular parathyroid disease.
  • Regarding solitary lesions, the sensitivity of parathyroid scintigraphy with Tc-agents was 97% and thallium 78%, while that of ultrasonography was 74%.
  • Concomitant thyroid disease had a non-significant effect on the results of parathyroid scintigraphy and ultrasonography.
  • CONCLUSIONS: Parathyroid scintigraphy, in conjunction with Sestamibi or Tetrofosmin, constitutes the most sensitive localizing technique as regards solitary lesions.
  • The complementary use of parathyroid scintigraphy and ultrasonography is beneficial and efficacious in areas with high prevalence of thyroid disease.
  • [MeSH-major] Hyperparathyroidism, Primary / radionuclide imaging. Hyperparathyroidism, Primary / ultrasonography. Thyroid Diseases / complications
  • [MeSH-minor] Adenoma / surgery. Adult. Aged. Aged, 80 and over. Female. Humans. Male. Middle Aged. Parathyroid Neoplasms / surgery. Preoperative Care. Prospective Studies. Sensitivity and Specificity. Technetium. Thallium

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  • (PMID = 16728384.001).
  • [ISSN] 1109-3099
  • [Journal-full-title] Hormones (Athens, Greece)
  • [ISO-abbreviation] Hormones (Athens)
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 7440-26-8 / Technetium; AD84R52XLF / Thallium
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3. Soon PS, Delbridge LW, Sywak MS, Barraclough BM, Edhouse P, Sidhu SB: Surgeon performed ultrasound facilitates minimally invasive parathyroidectomy by the focused lateral mini-incision approach. World J Surg; 2008 May;32(5):766-71
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • BACKGROUND: Minimally invasive parathyroidectomy (MIP) is now widely accepted where a single adenoma can be localized preoperatively.
  • In our unit, MIP is offered once a parathyroid adenoma is localized with a sestamibi (MIBI) scan, with or without a concordant neck ultrasound.
  • The aim of this study was to compare the accuracy of surgeon performed ultrasound (SUS) with radiologist performed ultrasound (RUS) in the localization of a parathyroid adenoma in MIBI-positive primary hyperparathyroidism (PHPT).
  • PATIENTS AND METHODS: This is a prospective study of patients undergoing parathyroidectomy for sporadic primary hyperparathyroidism (PHPT) from April 2005 to October 2006 at the University of Sydney Endocrine Surgical Unit.
  • Overall, RUS correctly localized the parathyroid adenomas in 121 of 148 (82%) patients.
  • Surgeon performed ultrasound correctly localized the abnormal parathyroid adenoma in 72 of 87 (83%) of cases.
  • There was no significant difference in the proportion of patients with single gland disease, double adenomas, or hyperplasia correctly localized by SUS or RUS.
  • Incorrect interpretation of ultrasound imaging was due to cystic degeneration in thyroid nodules, lymph nodes, retro-esophageal location of adenomas and ectopic and small parathyroid glands.
  • CONCLUSIONS: Surgeon performed ultrasound is a useful adjunctive tool to MIBI localization for facilitating MIP and when performed by experienced parathyroid surgeons, it can achieve accuracy rates equivalent to that of a dedicated parathyroid radiologist.
  • [MeSH-major] Adenoma / diagnostic imaging. Adenoma / surgery. Parathyroid Neoplasms / diagnostic imaging. Parathyroid Neoplasms / surgery. Parathyroidectomy / methods

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  • (PMID = 18224474.001).
  • [ISSN] 0364-2313
  • [Journal-full-title] World journal of surgery
  • [ISO-abbreviation] World J Surg
  • [Language] eng
  • [Publication-type] Controlled Clinical Trial; Journal Article
  • [Publication-country] United States
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4. Carney JA: Familial multiple endocrine neoplasia: the first 100 years. Am J Surg Pathol; 2005 Feb;29(2):254-74
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • In 1903, Erdheim described the case of an acromegalic patient with a pituitary adenoma and three enlarged parathyroid glands.
  • Fifty years later, Underdahl et al reported 8 patients with a syndrome of pituitary, parathyroid, and pancreatic islet adenomas.
  • The first of these described by Sipple in 1961 comprised pheochromocytoma, MTC, and parathyroid adenoma.
  • In 1974, Sizemore et al concluded that the MEN 2 category included two groups of patients with MTC and pheochromocytoma: one with parathyroid disease and a normal appearance (MEN 2A) and the other without parathyroid disease but with mucosal neuromas and mesodermal abnormalities (MEN 2B).

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  • (PMID = 15644784.001).
  • [ISSN] 0147-5185
  • [Journal-full-title] The American journal of surgical pathology
  • [ISO-abbreviation] Am. J. Surg. Pathol.
  • [Language] eng
  • [Publication-type] Historical Article; Journal Article; Portraits; Review
  • [Publication-country] United States
  • [Number-of-references] 92
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5. Callender GG, Grubbs EG, Vu T, Hofstetter WL, Fleming JB, Woodburn KL, Lee JE, Evans DB, Perrier ND: The fallen one: the inferior parathyroid gland that descends into the mediastinum. J Am Coll Surg; 2009 May;208(5):887-93; discussion 893-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The fallen one: the inferior parathyroid gland that descends into the mediastinum.
  • BACKGROUND: Inferior parathyroid glands are located along the embryologic migration path of the thymus and can rest in the thyrothymic ligament or anterior mediastinum.
  • This study reviews our experience with type F parathyroid glands to determine which can be retrieved successfully through a cervical incision.
  • Distance from the superior aspect of the clavicle to the target parathyroid gland was measured.
  • RESULTS: Sixty (9.2%) patients had a type F parathyroid gland.
  • Preoperative imaging identified parathyroid glands located >or=6 cm below the superior aspect of the clavicle in eight patients.
  • Parathyroidectomy was successfully performed through a cervical incision in all 52 (100%) patients in whom the target parathyroid gland was <6 cm below the superior aspect of the clavicle (Fisher's exact test, p < 0.001).
  • CONCLUSIONS: A cervical approach allows successful retrieval of type F parathyroid glands located <6 cm below the superior aspect of the head of the clavicle in the anterior mediastinum.
  • [MeSH-major] Adenoma / surgery. Parathyroid Neoplasms / surgery. Parathyroidectomy / methods
  • [MeSH-minor] Female. Humans. Hyperparathyroidism / surgery. Male. Middle Aged. Minimally Invasive Surgical Procedures. Parathyroid Glands / pathology. Reoperation. Retrospective Studies

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  • (PMID = 19476855.001).
  • [ISSN] 1879-1190
  • [Journal-full-title] Journal of the American College of Surgeons
  • [ISO-abbreviation] J. Am. Coll. Surg.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / P30 CA016672
  • [Publication-type] Journal Article
  • [Publication-country] United States
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6. Van den Hauwe K, Oeyen SG, Schrijvers BF, Decruyenaere JM, Buylaert WA: A 50-year-old man with severe hypercalcemia: a case report. Acta Clin Belg; 2009 Sep-Oct;64(5):442-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • OBJECTIVE: We present this case to emphasize the importance of early diagnosis and treatment of an acute severe hypercalcemic syndrome due to primary hyperparathyroidism as a consequence of an undiagnosed adenoma of the parathyroid gland.
  • Serum levels of calcium and parathyroid hormone (PTH) were markedly increased to 23.6 mg/dL (reference values 8.6-10.2 mg/dL) and > 1900 ng/L (reference values 14-72 ng/L) respectively.
  • A parathyroid adenoma was diagnosed and a few days later a parathyroidectomy was performed.
  • CONCLUSION: Acute primary hyperparathyroidism, also known as parathyroid storm or parathyroid crisis, is a rare but potentially fatal endocrine emergency if unrecognized and untreated.
  • Appropriate diagnosis and immediate adequate management of hypercalcemia are important in reducing mortality.
  • [MeSH-major] Hypercalcemia / diagnosis. Hypercalcemia / etiology. Hyperparathyroidism, Primary / complications
  • [MeSH-minor] Acute Disease. Adenoma / complications. Adenoma / radiography. Humans. Male. Middle Aged. Parathyroid Neoplasms / complications. Parathyroid Neoplasms / radiography. Parathyroidectomy. Tomography, X-Ray Computed

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  • (PMID = 19999395.001).
  • [ISSN] 1784-3286
  • [Journal-full-title] Acta clinica Belgica
  • [ISO-abbreviation] Acta Clin Belg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Belgium
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7. Portela-Gomes GM, Grimelius L, Stridsberg M: Secretogranin III in human neuroendocrine tumours: a comparative immunohistochemical study with chromogranins A and B and secretogranin II. Regul Pept; 2010 Nov 30;165(1):30-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • The expression of SgIII agreed well with that of CgA, CgB and SgII, with exceptions of phaeochromocytomas, where more CgB and SgII immunoreactive cells were observed and parathyroid adenomas, which were only stained by CgA.

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  • [Copyright] Copyright © 2010 Elsevier B.V. All rights reserved.
  • (PMID = 20550951.001).
  • [ISSN] 1873-1686
  • [Journal-full-title] Regulatory peptides
  • [ISO-abbreviation] Regul. Pept.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Chromogranin A; 0 / Chromogranin B; 0 / Chromogranins; 0 / Secretogranin II; 0 / secretogranin III
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8. Fuster D, Torregrosa JV, Setoain X, Doménech B, Campistol JM, Rubello D, Pons F: Localising imaging in secondary hyperparathyroidism. Minerva Endocrinol; 2008 Sep;33(3):203-12
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Localising imaging in secondary hyperparathyroidism.
  • Preoperative imaging has proved its use successful in the localization of solitary parathyroid adenomas in patients with suspected primary hyperparathyroidism.
  • However, due to multiglandular disease at presentation patients with renal hyperparathyroidism need to be analyzed separately, making the usefulness of imaging techniques controversial.
  • Recently, improved methods of functional imaging like parathyroid scan with 99mTc-sestamibi or positron emission tomography, especially when combined with computed tomography, can provide additional quantitative and qualitative information that has yet to be assessed.
  • Nuclear medicine procedures could prove useful not only in preoperative diagnosis, but also in the selection of medical or surgical therapeutic alternatives in secondary hyperparathyroidism patients.
  • There is evidence that 99mTc-sestamibi uptake in parathyroid hyperplasia or adenoma is related to biochemical markers of parathyroid function.
  • We are only beginning to identify the factors involved in radiotracer uptake by parathyroid cells and how it can be modulated to obtain more accurate results.
  • This review analyzes the current use of non-invasive imaging modalities in patients with secondary hyperparathyroidism, taking into account the latest trends in the field combining anatomic and functional modalities and the relevant factors linked to radiotracer uptake in abnormal hyperfunctioning parathyroid glands.
  • [MeSH-major] Diagnostic Imaging / methods. Hyperparathyroidism, Secondary / radionuclide imaging

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  • (PMID = 18846026.001).
  • [ISSN] 0391-1977
  • [Journal-full-title] Minerva endocrinologica
  • [ISO-abbreviation] Minerva Endocrinol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Organophosphorus Compounds; 0 / Organotechnetium Compounds; 0 / Radiopharmaceuticals; 0 / technetium Tc 99m 1,2-bis(bis(2-ethoxyethyl)phosphino)ethane; 971Z4W1S09 / Technetium Tc 99m Sestamibi; SY7Q814VUP / Calcium
  • [Number-of-references] 74
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9. Pimenta FJ, Gontijo Silveira LF, Tavares GC, Silva AC, Perdigão PF, Castro WH, Gomez MV, Teh BT, De Marco L, Gomez RS: HRPT2 gene alterations in ossifying fibroma of the jaws. Oral Oncol; 2006 Aug;42(7):735-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Recently, the candidate tumor suppressor gene HRPT2 was identified and alterations in this gene were related with the Hyperparathyroidism-jaw tumor syndrome that is characterized by parathyroid adenoma or carcinoma, fibro-osseous lesions (mainly OF) of the jaws, and renal lesions.

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  • (PMID = 16458039.001).
  • [ISSN] 1368-8375
  • [Journal-full-title] Oral oncology
  • [ISO-abbreviation] Oral Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / CDC73 protein, human; 0 / RNA, Messenger; 0 / RNA, Neoplasm; 0 / Tumor Suppressor Proteins
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10. Thrumurthy SG, Date RS, Mughal MM, Pursnani KG, Ward JB: The surgical management of pancreaticoduodenal tumours in multiple endocrine neoplasia type 1. BMJ Case Rep; 2009;2009
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Upon investigation, he was found to have renal stone disease secondary to a parathyroid adenoma.
  • Further tests revealed high pituitary hormone and gastrin values, confirming the diagnosis of multiple endocrine neoplasia type 1 (MEN 1) and Zollinger-Ellison syndrome.

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  • (PMID = 21686642.001).
  • [ISSN] 1757-790X
  • [Journal-full-title] BMJ case reports
  • [ISO-abbreviation] BMJ Case Rep
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC3027828
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11. Lang BH: Minimally invasive thyroid and parathyroid operations: surgical techniques and pearls. Adv Surg; 2010;44:185-98
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  • [Title] Minimally invasive thyroid and parathyroid operations: surgical techniques and pearls.
  • With advances in technology and greater demand for minimally invasive procedures, novel minimally invasive approaches to thyroid and parathyroid glands increasingly have been described and practiced worldwide.
  • The addition of the robot such as the de Vinci surgical system could make some of the extracervical approaches technically less challenging and improve patient outcomes.
  • Unlike MIT, MIP has become the standard approach for surgical management of primary hyperparathyroidism caused by localized solitary parathyroid adenoma.

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  • (PMID = 20919522.001).
  • [ISSN] 0065-3411
  • [Journal-full-title] Advances in surgery
  • [ISO-abbreviation] Adv Surg
  • [Language] ENG
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
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12. Bishop J, Brown E, Podesta A, Troy C, Dong XE: Surgical management of calciphylaxis associated with primary hyperparathyroidism: a case report and review of the literature. Int J Endocrinol; 2010;2010
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  • [Title] Surgical management of calciphylaxis associated with primary hyperparathyroidism: a case report and review of the literature.
  • Here, we present the unusual case of a 56-year-old woman, with extensive medical problems, who developed calciphylaxis in the presence of primary hyperparathyroidism.
  • The diagnosis of calciphylaxis was rendered histologically by extensive calcification of the subcutaneous blood vessels.
  • Subsequent parathyroidectomy identified the presence of a hyperactive mediastinal parathyroid adenoma, weighing 0.62 grams.
  • Postoperatively, the patient had normalization of hypercalcemia and parathyroid hormone levels, with subsequent healing of her thigh wounds.

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  • (PMID = 20885925.001).
  • [ISSN] 1687-8345
  • [Journal-full-title] International journal of endocrinology
  • [ISO-abbreviation] Int J Endocrinol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Egypt
  • [Other-IDs] NLM/ PMC2946589
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13. Weber T, Cammerer G, Schick C, Solbach C, Hillenbrand A, Barth TF, Henne-Bruns D, Blagieva R, Böhm BO, Reske SN, Luster M: C-11 methionine positron emission tomography/computed tomography localizes parathyroid adenomas in primary hyperparathyroidism. Horm Metab Res; 2010 Mar;42(3):209-14
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  • [Title] C-11 methionine positron emission tomography/computed tomography localizes parathyroid adenomas in primary hyperparathyroidism.
  • In patients with primary hyperparathyroidism (pHPT), positive preoperative localization studies enable to perform a minimally invasive approach for parathyroid surgery.
  • We therefore conducted a study to determine the sensitivity of C-11 methionine positron emission tomography/computed tomography (Met-PET/CT) in localizing parathyroid adenomas in pHPT.
  • Met-PET/CT scans of the neck and mediastinum of 33 patients undergoing parathyroidectomy for primary HPT were compared with intraoperative and histological findings.
  • Primary HPT was caused by a single gland adenoma in 30 patients, while another 3 patients had multiglandular disease.
  • Met-PET/CT scan correctly located a single gland adenoma in 25 out of 30 (83%) patients with pHPT, among them 2 patients with persistent disease, 7 patients with prior neck surgery, and 8 patients with concomitant thyroid nodules.
  • In 3 patients with multiglandular disease, Met-PET/CT showed only one enlarged parathyroid gland in two individuals and was negative in the third patient.
  • Statistical analysis found a significant correlation between true-positive results and the weight (2.42+/-4.05 g) and diameter (2.0+/-1.18 cm) of parathyroid adenomas while the subgroup with false negative findings had significantly smaller (0.98+/-0.54 cm) and lighter (0.5+/-0.38 g) glands.
  • Sensitivity was 83% for single gland adenomas and 67% for multiglandular disease.
  • Met-PET/CT correctly localized 83% of single gland parathyroid adenomas in patients with pHPT.
  • However, preoperative localization of multiglandular disease due to double adenomas or parathyroid hyperplasia remained difficult.
  • [MeSH-major] Adenoma / radionuclide imaging. Hyperparathyroidism, Primary / radionuclide imaging. Methionine. Parathyroid Neoplasms / radionuclide imaging. Positron-Emission Tomography. Tomography, X-Ray Computed

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  • (PMID = 20013649.001).
  • [ISSN] 1439-4286
  • [Journal-full-title] Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et métabolisme
  • [ISO-abbreviation] Horm. Metab. Res.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 58576-49-1 / carbon-11 methionine; AE28F7PNPL / Methionine
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14. Mahoney EJ, Monchik JM, Donatini G, De Lellis R: Life-threatening hypercalcemia from a hepatocellular carcinoma secreting intact parathyroid hormone: localization by sestamibi single-photon emission computed tomographic imaging. Endocr Pract; 2006 May-Jun;12(3):302-6
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  • [Title] Life-threatening hypercalcemia from a hepatocellular carcinoma secreting intact parathyroid hormone: localization by sestamibi single-photon emission computed tomographic imaging.
  • OBJECTIVE: To describe a patient with severe hypercalcemia and elevated intact parathyroid hormone (iPTH) levels associated with a hepatocellular carcinoma.
  • Findings on preoperative sestamibi scanning were suggestive of a parathyroid adenoma, with additional uptake in the dome of the liver.
  • He was diagnosed as having primary hyperparathyroidism, and a neck exploration was undertaken.
  • The right superior, right inferior, and left superior parathyroid glands were mildly enlarged and were excised.
  • The left inferior parathyroid gland could not be identified, despite an extensive neck exploration.
  • [MeSH-major] Carcinoma, Hepatocellular / secretion. Hypercalcemia / complications. Hypercalcemia / etiology. Liver Neoplasms / secretion. Parathyroid Hormone / blood
  • [MeSH-minor] Aged. Chemoembolization, Therapeutic. Fatal Outcome. Hormones, Ectopic / blood. Humans. Hyperparathyroidism / etiology. Male. Parathyroid Glands / surgery. Recurrence. Technetium Tc 99m Sestamibi. Tomography, Emission-Computed

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  • (PMID = 16772205.001).
  • [ISSN] 1530-891X
  • [Journal-full-title] Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
  • [ISO-abbreviation] Endocr Pract
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Hormones, Ectopic; 0 / Parathyroid Hormone; 971Z4W1S09 / Technetium Tc 99m Sestamibi
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15. Yun JS, Nam KH, Chung WY, Park CS: Giant posterior mediastinal parathyroid adenoma. Thyroid; 2008 Apr;18(4):475-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Giant posterior mediastinal parathyroid adenoma.
  • [MeSH-major] Adenoma / diagnosis. Mediastinum / pathology. Parathyroid Neoplasms / diagnosis
  • [MeSH-minor] Calcium / metabolism. Female. Humans. Middle Aged. Parathyroid Hormone / metabolism. Parathyroidectomy. Technetium Tc 99m Sestamibi / pharmacology. Time Factors. Tomography, Emission-Computed, Single-Photon / methods. Tomography, X-Ray Computed / methods. Treatment Outcome

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  • (PMID = 18399771.001).
  • [ISSN] 1050-7256
  • [Journal-full-title] Thyroid : official journal of the American Thyroid Association
  • [ISO-abbreviation] Thyroid
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Parathyroid Hormone; 971Z4W1S09 / Technetium Tc 99m Sestamibi; SY7Q814VUP / Calcium
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16. Toniato A, Pelizzo MR: Letter 1: Intraoperative diagnosis and treatment of parathyroid cancer and atypical parathyroid adenoma (Br J Surg 2007; 94: 566-570). Br J Surg; 2007 Aug;94(8):1042-3; author reply 1043-4
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  • [Title] Letter 1: Intraoperative diagnosis and treatment of parathyroid cancer and atypical parathyroid adenoma (Br J Surg 2007; 94: 566-570).
  • [MeSH-major] Adenoma / diagnosis. Parathyroid Neoplasms / diagnosis

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  • [CommentOn] Br J Surg. 2007 May;94(5):566-70 [17380564.001]
  • (PMID = 17636521.001).
  • [ISSN] 0007-1323
  • [Journal-full-title] The British journal of surgery
  • [ISO-abbreviation] Br J Surg
  • [Language] eng
  • [Publication-type] Comment; Letter
  • [Publication-country] England
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17. Shah-Patel LR, Ghesani M, Connery C, Moore E: Gamma Probe Detection of Ectopic Parathyroid Adenoma. Radiol Case Rep; 2008;3(1):161
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  • [Title] Gamma Probe Detection of Ectopic Parathyroid Adenoma.
  • This lesion was thought to be consistent with an ectopic parathyroid adenoma.
  • However, abnormal activity was localized to the thymus gland, from which an ectopic parathyroid adenoma was successfully excised.
  • The use of the intraoperative gamma probe was critical in identifying and resecting the ectopic parathyroid adenoma in this patient, and in general, may reduce surgical time and reduce the morbidity and/or complications associated with surgical exploration.

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  • (PMID = 27303512.001).
  • [ISSN] 1930-0433
  • [Journal-full-title] Radiology case reports
  • [ISO-abbreviation] Radiol Case Rep
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Netherlands
  • [Other-IDs] NLM/ PMC4896118
  • [Keywords] NOTNLM ; CT, computed tomography / MRI, magnetic resonance imaging / SPECT, single photon emission computed tomography / VATS, video-assisted thoracoscopic surgery
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18. Alabdulkarim Y, Nassif E: Sestamibi (99mTc) scan as a single localization modality in primary hyperparathyroidism and factors impacting its accuracy. Indian J Nucl Med; 2010 Jan;25(1):6-9
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  • [Title] Sestamibi (99mTc) scan as a single localization modality in primary hyperparathyroidism and factors impacting its accuracy.
  • BACKGROUND: The proper localization of a hypersecreting parathyroid gland is of vital importance for successful unilateral neck exploration (UNE) and parathyroidectomy.
  • AIM: In this study we aim to evaluate the (99mTc) sestamibi parathyroid scan as a single localizing modality, and we also assess its relation to the weight of the gland and to the preoperative parathyroid hormone (PTH) levels.
  • With primary hyperparathyroidism, all of them had (99mTc) sestamibi parathyroid scan for the localization of the parathyroid adenoma.
  • The histopathology reports confirmed the diagnosis and weight of the diseased gland, which were recorded every time.
  • Analyzing the mean weight of the gland in each group between matching (EM, PM) versus mismatch resulted in a mean difference of 0.823 g (1.05 and 0.247 g, respectively) P = 0.045.
  • Hyperplasia to adenoma ratio was more in the partial matching group (18.5%) versus the exact matching group (7.6%).
  • CONCLUSION: (99mTc) sestamibi is a highly accurate test that can be employed as a single localizing modality for identifying a hypersecreting parathyroid, a UNE, or a parathyroidectomy.
  • The weight of the gland plays an important role in the accuracy of the test, as also the preoperative PTH levels.

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  • (PMID = 20844661.001).
  • [ISSN] 0974-0244
  • [Journal-full-title] Indian journal of nuclear medicine : IJNM : the official journal of the Society of Nuclear Medicine, India
  • [ISO-abbreviation] Indian J Nucl Med
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] India
  • [Other-IDs] NLM/ PMC2934592
  • [Keywords] NOTNLM ; Localization / primary hyperparathyroidism / sestamibi (99mTc) scan
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19. Cayo A, Chen H: Radioguided reoperative parathyroidectomy for persistent primary hyperparathyroidism. Clin Nucl Med; 2008 Oct;33(10):668-70
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  • [Title] Radioguided reoperative parathyroidectomy for persistent primary hyperparathyroidism.
  • We report a case of reoperative radioguided parathyroidectomy in a patient with primary hyperparathyroidism.
  • A 58-year-old man presented to our center with persistent hypercalcemia and hyperparathyroidism after 2 previous parathyroid explorations at an outside facility.
  • Despite the use of preoperative and intraoperative localization, identification of the hyperfunctioning gland was unsuccessful during the initial operations.
  • Repeat Tc-99m sestamibi parathyroid scan showed an inferior right parathyroid adenoma.
  • With the intraoperative guidance of a hand-held gamma probe, an enlarged parathyroid gland was localized on the spine behind the esophagus on the right, and successfully removed.
  • Intraoperative parathyroid hormone testing confirmed a surgical cure.
  • The use of radioguidance and intraoperative parathyroid hormone testing were essential to the successful resection.
  • [MeSH-major] Hyperparathyroidism, Primary / radionuclide imaging. Hyperparathyroidism, Primary / surgery. Parathyroidectomy / methods. Surgery, Computer-Assisted / methods. Technetium Tc 99m Sestamibi

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  • (PMID = 18806564.001).
  • [ISSN] 1536-0229
  • [Journal-full-title] Clinical nuclear medicine
  • [ISO-abbreviation] Clin Nucl Med
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 971Z4W1S09 / Technetium Tc 99m Sestamibi
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20. Shaheen F, Chowdry N, Gojwari T, Wani AI, Khan S: Role of cervical ultrasonography in primary hyperparathyroidism. Indian J Radiol Imaging; 2008 Nov;18(4):302-5
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  • [Title] Role of cervical ultrasonography in primary hyperparathyroidism.
  • AIM: To evaluate the role of USG in the preoperative localization of parathyroid adenomas in patients with symptomatic hyperparathyroidism and to compare its usefulness with that of scintigraphy scan and postoperative findings.
  • MATERIAL AND METHODS: Twenty-five patients with symptomatic primary hyperparathyroidism were subjected to USG of the neck and nuclear scintigraphy, followed by surgery.
  • RESULTS: The 25 patients had a total of 28 abnormal glands: 22 solitary adenomas, and 6 multiple adenomas (two each in three patients).
  • USG detected 20 out of 22 solitary adenomas and three out of six multiple adenomas.
  • CONCLUSION: As limited neck dissection for primary hyperparathyroidism becomes increasingly popular, USG has been found to be a sensitive, specific, and easily available noninvasive investigation for parathyroid localization.
  • It can be easily offered to patients as a method for preoperative localization prior to limited parathyroid surgery outside tertiary care settings.

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  • (PMID = 19774186.001).
  • [ISSN] 0971-3026
  • [Journal-full-title] The Indian journal of radiology & imaging
  • [ISO-abbreviation] Indian J Radiol Imaging
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] India
  • [Other-IDs] NLM/ PMC2747464
  • [Keywords] NOTNLM ; Primary hyperparathyroidism / Tc-sestamibi scan / ultrasonography
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21. Norman J, Politz D: Measuring individual parathyroid gland hormone production in real-time during radioguided parathyroidectomy. Experience in over 8,000 operations. Minerva Endocrinol; 2008 Sep;33(3):147-57
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  • [Title] Measuring individual parathyroid gland hormone production in real-time during radioguided parathyroidectomy. Experience in over 8,000 operations.
  • AIM: Determining the physiologic activity (hormone production) of individual parathyroid glands by measuring their contained radioactivity is extremely accurate and provides tremendous guidance during parathyroidectomy.
  • METHODS: A single-surgeon's experience with over 8,000 radioguided parathyroidectomies, 7,500 of which were for primary, sporadic, non-MEN hyperparathyroidism (HPT).
  • Ex-vivo measures of parathyroid glands, thyroid nodules, lymph nodes, thymus, and fat were obtained from all patients, constituting over 42,000 specimens.
  • RESULTS: Parathyroid glands occur in three distinct groups according to their hormone production which very accurately indicates the type of pathology present.
  • Adenomas (N.=7 943) contained 59+/-35% of background radioactivity; hyperplastic glands (N.=876) contained 17+/-5%; and normal glands (N.=13 821) contained 4+/-0.1%, all P<0.00001).
  • CONCLUSIONS: Measures of sequestered radioactivity is an extremely accurate estimate of individual parathyroid gland hormone production allowing near 100% distinction between normal, hyperplasic, and adenomatous glands as well as distinguishing parathyroids from other neck tissues (fat, lymph nodes, thyroid).
  • This instantaneous measure can eliminate frozen sections and parathyroid hormone assays in nearly all patients undergoing parathyroid surgery, providing insight that allows the operation to progress rapidly.
  • [MeSH-major] Adenoma / secretion. Computer Systems. Parathyroid Glands / secretion. Parathyroid Hormone / biosynthesis. Parathyroid Neoplasms / secretion. Parathyroidectomy / methods. Surgery, Computer-Assisted / methods

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  • (PMID = 18846022.001).
  • [ISSN] 0391-1977
  • [Journal-full-title] Minerva endocrinologica
  • [ISO-abbreviation] Minerva Endocrinol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / PTH protein, human; 0 / Parathyroid Hormone; 0 / Radiopharmaceuticals; 971Z4W1S09 / Technetium Tc 99m Sestamibi; SY7Q814VUP / Calcium
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22. Szende B, Arvai K, Peták I, Nagy K, Végsô G, Perner F: [Changes in gene expression in the course of proliferative processes in the parathyroid gland]. Magy Onkol; 2006;50(2):137-40
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  • [Title] [Changes in gene expression in the course of proliferative processes in the parathyroid gland].
  • The aim of this study was to investigate the changes in expression pattern of the most important genes connected with apoptosis in proliferative apoptotic lesions (hyperplasia, adenoma), applying cDNA microarray technique, in order to promote the possible diagnostic or therapeutic utilisation of any difference in gene expression compared to the healthy (normal) parathyroid gland.
  • Samples were taken from surgically removed 2 hyperplasias, 2 adenomas and 2 normal parathyroid glands.
  • The samples deriving from hyperplasia or adenoma were compared to samples from normal parathyroid glands.
  • The following genes were overexpressed in both hyperplasia and adenoma: CHEK1, ATM, BCL-XL, FAS, TNF, cIAP1, TRAIL, FADD, CASP 4,5,6,8, CD120b, CD137, LTA, TANK, TARF2, CAD, LIGHTR, DR3LG.
  • CASP1,10, BFAR, BOD, BCL2L2, TRANCE were underexpressed in both hyperplasia and adenoma.
  • Overexpressed only in adenoma: APOLLON, RIPK1, LTB, LTBR, CASP2,13, cIAP2, CIDEB.
  • Underexpressed only in adenoma: TRAF4 and FASLG.
  • As a result of this study, both pro-apoptotic and antiapoptotic genes were identified in hyperplasia and adenoma of the parathyroid gland.
  • [MeSH-major] Adenoma / genetics. Apoptosis / genetics. Gene Expression. Gene Expression Regulation, Neoplastic. Parathyroid Glands / metabolism. Parathyroid Neoplasms / genetics


23. Pai SI, Goldstein BJ, Studeman KD, Westra WH, Tufano RP: Concurrent sporadic parathyroid adenoma and carcinoma. Am J Otolaryngol; 2006 Sep-Oct;27(5):346-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Concurrent sporadic parathyroid adenoma and carcinoma.
  • [MeSH-major] Adenoma / diagnosis. Carcinoma / diagnosis. Neoplasms, Multiple Primary / diagnosis. Parathyroid Neoplasms / diagnosis
  • [MeSH-minor] Aged. Calcium / blood. Diagnosis, Differential. Humans. Male. Parathyroid Hormone / blood. Parathyroidectomy

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  • (PMID = 16935182.001).
  • [ISSN] 0196-0709
  • [Journal-full-title] American journal of otolaryngology
  • [ISO-abbreviation] Am J Otolaryngol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Parathyroid Hormone; SY7Q814VUP / Calcium
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24. Ahmad S, Mufti TS, Khan AA, Ahmad S: Parathyroid carcinoma. J Ayub Med Coll Abbottabad; 2006 Apr-Jun;18(2):84-5
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  • [Title] Parathyroid carcinoma.
  • Parathyroid carcinoma is a very rare cause of primary hyperparathyroidism and these tumors are usually hyper-functioning as compared to other malignant endocrine tumors.
  • Surgery is the only effective primary treatment.
  • Parathyroid adenoma was initially diagnosed and localized at left lower gland by Sestamibi scan and ultrasonography.
  • She underwent surgery and enlarged parathyroid gland was removed.
  • [MeSH-major] Adenoma / diagnosis. Parathyroid Neoplasms / diagnosis
  • [MeSH-minor] Diagnosis, Differential. Female. Humans. Middle Aged

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  • (PMID = 16977824.001).
  • [ISSN] 1025-9589
  • [Journal-full-title] Journal of Ayub Medical College, Abbottabad : JAMC
  • [ISO-abbreviation] J Ayub Med Coll Abbottabad
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Pakistan
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25. Alavi MS, Azarpira N, Mojallal M: Incidental finding of bilateral papillary thyroid carcinoma in a patient with primary hyperparathyroidism. Hell J Nucl Med; 2010 Jan-Apr;13(1):56-8
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  • [Title] Incidental finding of bilateral papillary thyroid carcinoma in a patient with primary hyperparathyroidism.
  • Primary hyperparathyroidism (PHP) affects 0.5%-1% of the adult population and presents with classical signs of renal lithiasis, cholecystolithiasis, gastrointestinal ulcerations, depression, and osteoporosis.
  • Parathyroid adenoma, hyperplasia and rarely carcinoma are the underlying pathology.
  • Synchronous thyroid and parathyroid pathologies are described in multiple endocrine neoplasia.
  • We report a case of a 47 years old woman with non-syndromic concomitant occurrence of bilateral non-medullary thyroid carcinoma diagnosed by histopathology, and with PHP confirmed by (99m)Tc-MIBI scintigraphy, hypercalcemia and elevated serum parathyroid hormone.
  • A head and neck surgeon needs to be aware of the possible coexistence of thyroid and parathyroid lesions.
  • [MeSH-major] Carcinoma, Papillary / complications. Carcinoma, Papillary / radionuclide imaging. Hyperparathyroidism / complications. Hyperparathyroidism / radionuclide imaging. Technetium Tc 99m Sestamibi. Thyroid Neoplasms / complications. Thyroid Neoplasms / radionuclide imaging

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  • (PMID = 20411173.001).
  • [ISSN] 1790-5427
  • [Journal-full-title] Hellenic journal of nuclear medicine
  • [ISO-abbreviation] Hell J Nucl Med
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 971Z4W1S09 / Technetium Tc 99m Sestamibi
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26. Ros S, Sitges-Serra A, Pereira JA, Jimeno J, Prieto R, Sancho JJ, Pérez-Ruiz L: [Intrathyroid parathyroid adenomas: right and lower]. Cir Esp; 2008 Oct;84(4):196-200
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  • [Title] [Intrathyroid parathyroid adenomas: right and lower].
  • [Transliterated title] Adenomas paratiroideos de localización intratiroidea: derechos y bajos.
  • INTRODUCTION: Intrathyroidal parathyroid adenomas (IPA) are a not an uncommon cause of persistent hyperparathyroidism.
  • PATIENTS AND METHOD: Retrospective review of prospectively recorded surgical protocols of patients having had parathyroidectomy for primary (n = 437) or secondary (n = 137) hyperparathyroidism by the same surgeon.
  • [MeSH-major] Adenoma / surgery. Multiple Endocrine Neoplasia Type 1 / surgery. Parathyroid Neoplasms / surgery. Parathyroidectomy. Thyroid Neoplasms / surgery. Thyroidectomy

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  • (PMID = 18928769.001).
  • [ISSN] 0009-739X
  • [Journal-full-title] Cirugía española
  • [ISO-abbreviation] Cir Esp
  • [Language] spa
  • [Publication-type] Comparative Study; English Abstract; Journal Article
  • [Publication-country] Spain
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27. Ruggeri RM, Calamoneri E, Russo A, Sindoni A, Mondello B, Monaco M, Rosa MA, Baldari S, Benvenga S, Campennì A, Trimarchi F: Supra-acetabular brown tumor due to primary hyperparathyroidism associated with chronic renal failure. ScientificWorldJournal; 2010;10:799-805
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  • [Title] Supra-acetabular brown tumor due to primary hyperparathyroidism associated with chronic renal failure.
  • 99mTc-MIBI scintigraphy revealed a single focus of sestamibi accumulation in the left retrosternal location, which turned out to be an intrathoracic parathyroid adenoma at surgical exploration.
  • After surgical removal of the parathyroid adenoma, PTH levels decreased to 212 pg/ml.
  • This case is noteworthy because (1) primary hyperparathyroidism was not suspected due to the normocalcemia, likely attributable to the coexistence of chronic renal failure; and (2) it was associated with a brown tumor of unusual location (right supra-acetabular region).
  • [MeSH-major] Bone Neoplasms / diagnosis. Hyperparathyroidism, Primary / complications. Kidney Failure, Chronic / complications


28. Richmond BK, Eads K, Flaherty S, Belcher M, Runyon D: Complications of thyroidectomy and parathyroidectomy in the rural community hospital setting. Am Surg; 2007 Apr;73(4):332-6
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  • The objective of this study was to examine the complications encountered in a series of 150 consecutive thyroid and parathyroid procedures performed by a single surgeon in a rural community hospital setting.
  • Specifically, these include intraoperative parathyroid hormone measurements, intraoperative recurrent laryngeal nerve monitoring, and the use of the gamma probe for detection of parathyroid adenoma.
  • A retrospective chart review was conducted on a series of 150 patients undergoing any thyroid or parathyroid operation by a single surgeon in a rural setting over a 4-year period.
  • One hundred thirty-one thyroid procedures were performed (71 lobectomies, 60 total or near total procedures) for a diverse range of patholological conditions: multinodular goiter, 76 (50.7%) patients, follicular adenoma, 9 (6.0%) patients, Hashimoto's thyroiditis, 13 (8.7%) patients, papillary carcinoma, 14 (9.3%) patients, follicular carcinoma, 5 (3.3%) patients, follicular variant of papillary carcinoma, 13 (8.7%) patients, and medullary carcinoma, 1 (0.7%) patient.
  • Nineteen successful parathyroid explorations were performed for primary hyperparathyroidism.
  • The success of identifying parathyroid adenoma was 100 per cent, despite the absence of intraoperative parathormone assays, and the decision not to perform radio-guided parathyroidectomy.
  • We conclude that outcomes and complications in thyroid and parathyroid surgical procedures are largely dependent on surgeon skill and experience, and can be performed safely in the community setting by an experienced general surgeon despite the absence of advanced technology in this setting.

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  • (PMID = 17439023.001).
  • [ISSN] 0003-1348
  • [Journal-full-title] The American surgeon
  • [ISO-abbreviation] Am Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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29. Chen H, Pruhs Z, Starling JR, Mack E: Intraoperative parathyroid hormone testing improves cure rates in patients undergoing minimally invasive parathyroidectomy. Surgery; 2005 Oct;138(4):583-7; discussion 587-90
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  • [Title] Intraoperative parathyroid hormone testing improves cure rates in patients undergoing minimally invasive parathyroidectomy.
  • BACKGROUND: Intraoperative parathyroid hormone (iPTH) testing often is used during minimally invasive parathyroidectomy for primary hyperparathyroidism (1 degrees HPT).
  • From January 1990 to June 2004, there were 345 consecutive patients with 1 degrees HPT and positive localization studies for a single parathyroid adenoma who were candidates for minimally invasive parathyroidectomy.
  • Group 1 patients (n = 157) underwent parathyroid exploration without iPTH testing and group 2 patients (n = 188) had an operation with iPTH testing.
  • RESULTS: Of the group 1 patients, 15 (10%) still were hypercalcemic postoperatively owing to additional unidentified hyperfunctioning parathyroid glands.
  • In contrast, among 188 group 2 patients, 170 (90%) had resection of a single parathyroid adenoma, a greater than 50% decrease in iPTH levels, and were cured.
  • Of these 18 patients, 9 had double adenomas and 9 had 3- or 4-gland hyperplasia.
  • [MeSH-major] Hyperparathyroidism, Primary / blood. Hyperparathyroidism, Primary / surgery. Intraoperative Care. Minimally Invasive Surgical Procedures. Parathyroid Hormone / blood. Parathyroidectomy
  • [MeSH-minor] Adenoma / complications. Humans. Hyperplasia. Middle Aged. Parathyroid Glands / pathology. Parathyroid Neoplasms / complications. Retrospective Studies. Treatment Outcome

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  • (PMID = 16269285.001).
  • [ISSN] 0039-6060
  • [Journal-full-title] Surgery
  • [ISO-abbreviation] Surgery
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Parathyroid Hormone
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30. Heizmann O, Viehl CT, Schmid R, Müller-Brand J, Müller B, Oertli D: Impact of concomitant thyroid pathology on preoperative workup for primary hyperparathyroidism. Eur J Med Res; 2009 Jan 28;14(1):37-41
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  • [Title] Impact of concomitant thyroid pathology on preoperative workup for primary hyperparathyroidism.
  • BACKGROUND: The former standard surgical treatment in patients with primary hyperparathyroidism (pHPT) has been bilateral cervical exploration.
  • The aim of the present study is to evaluate the value of MIP in respect to coexisting thyroid findings and their impact on preoperative workup for primary hyperparathyroidism.
  • The conversion rate to a four gland exploration was 6% (1/18).
  • Among patients having pHPT without any thyroid pathology, the adenoma localization is correct with either ultrasonography or 99m Tc-MIBI scintigraphy in the majority of cases.
  • [MeSH-major] Adenoma / complications. Hyperparathyroidism / complications. Thyroid Neoplasms / complications
  • [MeSH-minor] Adult. Aged. Female. Humans. Male. Middle Aged. Minimally Invasive Surgical Procedures / methods. Monitoring, Intraoperative / methods. Parathyroid Hormone / blood. Parathyroidectomy. Preoperative Care. Prospective Studies. Reproducibility of Results. Technetium Tc 99m Sestamibi / administration & dosage

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  • (PMID = 19258209.001).
  • [ISSN] 0949-2321
  • [Journal-full-title] European journal of medical research
  • [ISO-abbreviation] Eur. J. Med. Res.
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Parathyroid Hormone; 971Z4W1S09 / Technetium Tc 99m Sestamibi
  • [Other-IDs] NLM/ PMC3352203
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31. Moore FD Jr: Are scintigraphy, ultrasonography, and the parathyroid hormone assay necessary to identify solitary parathyroid adenomas? Nat Clin Pract Endocrinol Metab; 2007 Mar;3(3):214-5
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  • [Title] Are scintigraphy, ultrasonography, and the parathyroid hormone assay necessary to identify solitary parathyroid adenomas?

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  • [CommentOn] Clin Endocrinol (Oxf). 2006 Jul;65(1):106-13 [16817828.001]
  • (PMID = 17262065.001).
  • [ISSN] 1745-8366
  • [Journal-full-title] Nature clinical practice. Endocrinology & metabolism
  • [ISO-abbreviation] Nat Clin Pract Endocrinol Metab
  • [Language] eng
  • [Publication-type] Comment; Journal Article
  • [Publication-country] England
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32. Berber E, Parikh RT, Ballem N, Garner CN, Milas M, Siperstein AE: Factors contributing to negative parathyroid localization: an analysis of 1000 patients. Surgery; 2008 Jul;144(1):74-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Factors contributing to negative parathyroid localization: an analysis of 1000 patients.
  • BACKGROUND: Localizing studies are the key for determining the optimal surgical strategy in patients with primary hyperparathyroidism (HP).
  • This is a prospective study looking at the characteristics of the patient and the gland that determine the likelihood of an abnormal parathyroid to be detected by ultrasonography (US) and sestamibi scan (MIBI).
  • The study group included HP with single gland disease (63%), double adenoma (15%), as well as hyperplasia (15%), familial HP (2%), and secondary/tertiary HP (6%).
  • On multivariate analysis, body mass index (BMI), gland size, and gland volume were the statistically significant independent factors predicting detection by both US and MIBI in primary HP.
  • The sensitivity of US was better for single gland disease than for multigland disease in primary HP, but the sensitivity of MIBI was similar in both groups.
  • For a given size, hyperplastic glands in primary HP imaged less well with US and MIBI than in familial or secondary/tertiary HP.
  • CONCLUSION: This prospective study demonstrates that BMI and gland size independently predict accurate detection of abnormal parathyroid glands by US and MIBI in sporadic primary HP.
  • Understanding the factors that affect the accuracy of parathyroid localization tests will allow the surgeon to develop a successful surgical strategy in a given patient.
  • [MeSH-major] Hyperparathyroidism / diagnosis. Parathyroid Glands / radionuclide imaging. Parathyroid Glands / ultrasonography

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  • (PMID = 18571587.001).
  • [ISSN] 1532-7361
  • [Journal-full-title] Surgery
  • [ISO-abbreviation] Surgery
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 971Z4W1S09 / Technetium Tc 99m Sestamibi
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33. Fery-Blanco C, Prati C, Ornetti P, Bevalot J, Streit G, Toussirot E, Wendling D: [Hypercalcemia of double origin: association of multiple myeloma and ectopic parathyroidal adenoma]. Rev Med Interne; 2007 Jul;28(7):504-6
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  • [Title] [Hypercalcemia of double origin: association of multiple myeloma and ectopic parathyroidal adenoma].
  • INTRODUCTION: Multiple myeloma and primary hyperparathyroidism are two causes of hypercalcemia.
  • Biopsy diagnosed an ectopic parathyroidal adenoma.
  • DISCUSSION: Multiple myeloma and primary hyperparathyroidism can be associated.
  • Hypophosphoremia can suggest the diagnosis of hyperparathyroidism.
  • Both this observation and litterature (about twenty case reports) suggest that this double diagnosis should be systematicly evoked and explored by an assay of parathormone and a seric proteins electrophoresis in all hypercalcemia.
  • CONCLUSION: Multiple myeloma and parathyroidal adenoma should be both explored in all hypercalcemia, because they can be associated.

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  • (PMID = 17395337.001).
  • [ISSN] 0248-8663
  • [Journal-full-title] La Revue de medecine interne
  • [ISO-abbreviation] Rev Med Interne
  • [Language] FRE
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] France
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34. Efremidou EI, Papageorgiou MS, Pavlidou E, Manolas KJ, Liratzopoulos N: Parathyroid apoplexy, the explanation of spontaneous remission of primary hyperparathyroidism: a case report. Cases J; 2009 Mar 10;2:6399
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  • [Title] Parathyroid apoplexy, the explanation of spontaneous remission of primary hyperparathyroidism: a case report.
  • Primary hyperparathyroidism due to parathyroid adenoma represents an endocrine disease that is usually treated by surgical intervention (parathyroidectomy).
  • In a very few patients, primary hyperparathyroidism can be spontaneously remit either by infraction or hemorrhage of the adenoma,a fact that is almost certain that will not lead to complete and definite cure.
  • We describe a similar case of a 59-year-old male patient who underwent surgery for a cystic degeneration of a parathyroid adenoma, with substantial preoperative reduction of parathyroid hormone and calcium serum levels,and the diagnostic and treatment modalities are discussed, with a brief review of the current literature.

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  • (PMID = 20184676.001).
  • [ISSN] 1757-1626
  • [Journal-full-title] Cases journal
  • [ISO-abbreviation] Cases J
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2827073
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35. Szyfter W, Wierzbicka M, Balcerowiak A: [Is endoscopic neck surgery the future direction in neck treatment?]. Otolaryngol Pol; 2007;61(4):378-82
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  • The endoscopic surgery offered a valuable approach for chosen lesions of the neck (solitary parathyroid adenoma, thyroid nodules less then 35 mm, submandibular gland sialolithiasis or tumors).

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  • (PMID = 18260217.001).
  • [ISSN] 0030-6657
  • [Journal-full-title] Otolaryngologia polska = The Polish otolaryngology
  • [ISO-abbreviation] Otolaryngol Pol
  • [Language] pol
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Poland
  • [Number-of-references] 28
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36. Charrié A, Chikh K, Peix JL, Berger N, Decaussin M, Veber S, Bienvenu J, Lifante JC, Fabien N: Calcium-sensing receptor autoantibodies in primary hyperparathyroidism. Clin Chim Acta; 2009 Aug;406(1-2):94-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Calcium-sensing receptor autoantibodies in primary hyperparathyroidism.
  • BACKGROUND: Mutations in the extracellular calcium-sensing receptor (CaSR) gene are known to be implicated in some cases of primary hyperparathyroidism.
  • However, not all patients display such mutations and so the mechanisms of primary hyperparathyroidism are still largely unknown.
  • The aim of our study was to investigate the presence of CaSR autoantibodies in a large cohort of patients with primary hyperparathyroidism.
  • METHODS: Seventy-five patients were tested for the presence of anti-parathyroid antibodies using an immunoblotting assay with the recombinant extracellular domain of the human CaSR and an immunofluorescence technique with parathyroid adenoma.
  • There was no statistically significant difference in the decrease of parathyroid hormone (PTH) level after surgery between patients with or without autoantibodies.
  • Histological examination of parathyroid tissue did not show greater lymphocytic infiltration in patients with autoantibodies than in those without.
  • CONCLUSIONS: This study confirmed that some patients with primary hyperparathyroidism displayed CaSR autoantibodies.
  • The pathophysiological role of these autoantibodies in hyperparathyroidism needs to be further elucidated.
  • [MeSH-major] Autoantibodies / immunology. Hyperparathyroidism, Primary / immunology. Receptors, Calcium-Sensing / immunology
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Autoimmune Diseases / blood. Autoimmune Diseases / immunology. Autoimmune Diseases / pathology. Autoimmune Diseases / surgery. Calcium / blood. Cohort Studies. Female. Humans. Male. Middle Aged. Parathyroid Hormone / blood

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  • (PMID = 19520070.001).
  • [ISSN] 1873-3492
  • [Journal-full-title] Clinica chimica acta; international journal of clinical chemistry
  • [ISO-abbreviation] Clin. Chim. Acta
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Autoantibodies; 0 / Parathyroid Hormone; 0 / Receptors, Calcium-Sensing; SY7Q814VUP / Calcium
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37. Masi G, Barzon L, Iacobone M, Viel G, Porzionato A, Macchi V, De Caro R, Favia G, Palù G: Clinical, genetic, and histopathologic investigation of CDC73-related familial hyperparathyroidism. Endocr Relat Cancer; 2008 Dec;15(4):1115-26
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  • [Title] Clinical, genetic, and histopathologic investigation of CDC73-related familial hyperparathyroidism.
  • CDC73 (HRPT2) germline mutations are responsible for more than half of cases of hyperparathyroidism-jaw tumor syndrome (HPT-JT) and for a subset of familial isolated HPT (FIHP).
  • HPT-JT and FIHP patients had similar laboratory, clinical, and demographic features and shared primary HPT and other neoplasms, the most common of which was uterine polyposis.
  • Genetic analysis of tumor samples demonstrated a second somatic CDC73 mutation only in a parathyroid adenoma and no cases with the loss of the wild-type allele or methylation of the CDC73 promoter, even though immunohistochemical analysis demonstrated the loss of nuclear parafibromin expression in all tumors, including a uterine polyp.
  • [MeSH-major] Hyperparathyroidism, Primary / genetics. Jaw Neoplasms / genetics. Mutation / genetics. Neoplastic Syndromes, Hereditary / genetics. Parathyroid Neoplasms / genetics. Tumor Suppressor Proteins / genetics


38. Bahar G, Feinmesser R, Joshua BZ, Shpitzer T, Morgenstein S, Popovtzer A, Shvero J: Hyperfunctioning intrathyroid parathyroid gland: a potential cause of failure in parathyroidectomy. Surgery; 2006 Jun;139(6):821-6
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  • [Title] Hyperfunctioning intrathyroid parathyroid gland: a potential cause of failure in parathyroidectomy.
  • However, in rare patients, ectopic hyperfunctioning parathyroid glands may be located in the thyroid but missed on imaging studies or during surgery.
  • The aim of the present study was to evaluate the perioperative findings in 6 patients with intrathyroid parathyroid glands treated for hyperparathyroidism in our center over a 5-year period and to review the relevant literature.
  • METHODS: Of the 426 patients who underwent parathyroidectomy for hyperparathyroidism between 1998 and 2003 in our center, 6 (1.4%) were found to have intrathyroid glands.
  • Their files were reviewed for clinical features, surgical approach, intraoperative findings, parathyroid gland location, and morphologic and histopathologic characteristics.
  • The diagnosis in all patients was based on an increase in serum calcium concentration (10.1-13 mg/100 mL) and parathyroid hormone level (102-320 pg/mL).
  • When the parathyroid glands were not identified, bilateral neck and mediastinum were explored.
  • Adenoma was diagnosed histologically in 4 patients; 2 had a double adenoma.
  • CONCLUSION: Intrathyroid parathyroid gland is a rare condition in patients with hyperparathyroidism.
  • In these patients, imaging may miss the pathologic gland.
  • Despite its rarity, the possibility of an intrathyroid parathyroid should be kept in mind, and, when meticulous bilateral exploration of the neck fails to identity the hyperfunctioning gland, the surgeon should consider hemithyroidectomy.
  • [MeSH-major] Choristoma / complications. Hyperparathyroidism / etiology. Parathyroid Glands / pathology. Parathyroidectomy / adverse effects
  • [MeSH-minor] Aged. Female. Humans. Male. Middle Aged. Thyroid Gland / pathology

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  • (PMID = 16782440.001).
  • [ISSN] 0039-6060
  • [Journal-full-title] Surgery
  • [ISO-abbreviation] Surgery
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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39. Palermo A, Mulè G, Guarneri M, Arsena R, Riccobene R, Lorito MC, Vaccaro F, Cerasola G, Cottone S: Parathyroid hormone is inversely related to endothelin-1 in patients on haemodialysis. Nephrology (Carlton); 2008 Dec;13(6):467-71
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  • [Title] Parathyroid hormone is inversely related to endothelin-1 in patients on haemodialysis.
  • AIM: Parathyroid hormone secretion is mainly influenced by hypocalcaemia, hyperphosphataemia and vitamin D deficiency.
  • However, previous in vitro and in vivo studies showed that endothelin-1 can influence parathyroid hormone secretion.
  • METHODS: Parathyroid hormone and endothelin-1 plasma concentrations were measured in 67 haemodialysed patients.
  • Patients with history of cardiovascular diseases and those with parathyroid adenoma were excluded.
  • RESULTS: Plasma levels of endothelin-1 were found to be inversely related to those of parathyroid hormone (P < 0.04) The multiple regression analysis, carried out considering parathyroid hormone as a dependent variable, and including age, sex, blood pressure, calcium x phosphorus product, and endothelin-1, demonstrated that the independent correlates of parathyroid hormone were endothelin-1 (beta = -0.276; P = 0.015), and calcium x phosphorus product (beta = 0.417; P < 0.0001).
  • CONCLUSION: For the first time in vivo, we demonstrated an inverse independent relationship between endothelin-1 and parathyroid hormone in haemodialysed patients.
  • Because both endothelin-1 and parathyroid hormone are endowed with well-known harmful actions on cardiovascular apparatus, whether such inverse relation may really influence the natural history of cardiovascular damage due to secondary hyperparathyroidism remains to be elucidated.
  • [MeSH-major] Endothelin-1 / blood. Kidney Failure, Chronic / blood. Parathyroid Hormone / blood. Renal Dialysis

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  • [CommentIn] Nephrology (Carlton). 2008 Dec;13(6):465-6 [19138206.001]
  • (PMID = 18518931.001).
  • [ISSN] 1440-1797
  • [Journal-full-title] Nephrology (Carlton, Vic.)
  • [ISO-abbreviation] Nephrology (Carlton)
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Australia
  • [Chemical-registry-number] 0 / Endothelin-1; 0 / PTH protein, human; 0 / Parathyroid Hormone
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40. Raghay K, García-Caballero T, Nogueiras R, Morel G, Beiras A, Diéguez C, Gallego R: Ghrelin localization in rat and human thyroid and parathyroid glands and tumours. Histochem Cell Biol; 2006 Mar;125(3):239-46
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  • [Title] Ghrelin localization in rat and human thyroid and parathyroid glands and tumours.
  • In the current study, we use molecular biology to detect ghrelin transcripts expression in rats, and immunohistochemical techniques to investigate the cellular distribution of this peptide in rat and human thyroid and parathyroid glands and tumours.
  • Ghrelin was localized in thyroid C cells and in parathyroid cells.
  • Thyroid carcinomas (medullar, follicular and papillary) and parathyroid adenomas also showed intense and diffuse immunostaining for ghrelin.
  • The diffuse ghrelin immunostaining found in the parathyroid gland opens up the possibility of its secretion to the bloodstream or its involvement in the regulation of the parathyroid function.
  • Overall, expression of ghrelin in human and rat thyroid and parathyroid glands is highly suggestive of a conserved role of this molecule in the regulation of thyroid and parathyroid cell function.
  • [MeSH-major] Parathyroid Glands / metabolism. Parathyroid Neoplasms / metabolism. Peptide Hormones / metabolism. Thyroid Gland / metabolism. Thyroid Neoplasms / metabolism

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  • (PMID = 16187069.001).
  • [ISSN] 0948-6143
  • [Journal-full-title] Histochemistry and cell biology
  • [ISO-abbreviation] Histochem. Cell Biol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / DNA Primers; 0 / Ghrelin; 0 / Peptide Hormones; 0 / RNA, Messenger
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41. von Breitenbuch P, Iesalnieks I, Piso P, Schlitt HJ, Agha A: [Primary hyperparathyroidism: clinical symptoms, diagnostic significance and localisation--a retrospective analysis]. Zentralbl Chir; 2007 Dec;132(6):497-503
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  • [Title] [Primary hyperparathyroidism: clinical symptoms, diagnostic significance and localisation--a retrospective analysis].
  • BACKGROUND: The primary hyperparathyroidism (pHPT) is one of the most frequent metabolic diseases.
  • Moreover, the question of the best localisation-diagnostics and the most frequent localisation of the adenoma is not yet clarified.
  • New operation strategies and more cost-efficient strategies for diagnostic and therapy could be developed due to the clinically established electrochemiluminescence immunoassay for intraoperative monitoring of intact parathyroid hormone (iPTH).
  • The best preoperative diagnostic procedure for localisation of the adenoma of the parathyroid gland, in non preoperated patients, seemed to be the combination of ultrasound and scintigraphy.
  • The most common localisation of the adenoma was caudal, on the left side.
  • Today, the combination of iPTH-monitoring and minimal invasive unilateral cervical exploration should be considered as standard in the surgery of the adrenal gland.
  • Due to our data we recommend an exploration of the left caudal parathyroid gland first if the localisation of the adenoma could not be clarified preoperatively.
  • [MeSH-major] Adenoma / diagnosis. Electrodiagnosis. Hyperparathyroidism, Primary / diagnosis. Luminescent Measurements. Monitoring, Intraoperative. Parathyroid Hormone / blood. Parathyroid Neoplasms / diagnosis
  • [MeSH-minor] Diagnosis, Differential. Diagnostic Imaging. Female. Humans. Hyperparathyroidism, Secondary / blood. Hyperparathyroidism, Secondary / diagnosis. Hyperparathyroidism, Secondary / surgery. Male. Minimally Invasive Surgical Procedures. Postoperative Complications / blood. Postoperative Complications / etiology. Retrospective Studies

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  • [ErratumIn] Zentralbl Chir. 2008 Feb;133(1):85. Pompiliu, P [corrected to Piso, P]
  • (PMID = 18098076.001).
  • [ISSN] 0044-409X
  • [Journal-full-title] Zentralblatt für Chirurgie
  • [ISO-abbreviation] Zentralbl Chir
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Parathyroid Hormone
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42. Graff-Baker A, Roman SA, Boffa D, Aslanian H, Sosa JA: Diagnosis of ectopic middle mediastinal parathyroid adenoma using endoscopic ultrasonography-guided fine-needle aspiration with real-time rapid parathyroid hormone assay. J Am Coll Surg; 2009 Sep;209(3):e1-4
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  • [Title] Diagnosis of ectopic middle mediastinal parathyroid adenoma using endoscopic ultrasonography-guided fine-needle aspiration with real-time rapid parathyroid hormone assay.
  • [MeSH-major] Endosonography. Mediastinal Neoplasms / pathology. Parathyroid Glands / pathology. Parathyroid Neoplasms / pathology
  • [MeSH-minor] Aged. Biopsy, Fine-Needle. Diagnosis, Differential. Female. Humans. Thoracic Surgery, Video-Assisted

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  • (PMID = 19717031.001).
  • [ISSN] 1879-1190
  • [Journal-full-title] Journal of the American College of Surgeons
  • [ISO-abbreviation] J. Am. Coll. Surg.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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43. Souza ER, Scrignoli JA, Bezerra FC, Ribeiro SL, Passos LF: Devastating skeletal effects of delayed diagnosis of complicated primary hyperparathyroidism because of ectopic adenoma. J Clin Rheumatol; 2008 Oct;14(5):281-4
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  • [Title] Devastating skeletal effects of delayed diagnosis of complicated primary hyperparathyroidism because of ectopic adenoma.
  • Primary hyperparathyroidism is a disease caused by exaggerated secretion of the parathyroid gland hormone, produced by an adenoma in 80% of cases.
  • Ectopic adenomas occur in a small proportion of cases.
  • Herein, the authors report a 72-year-old woman with a delayed diagnosis of primary hyperparathyroidism, produced by an intrathoracic adenoma, with a longstanding course, presenting with severe osteoporosis, multiple fractures, bone deformities, and neurologic impairments.
  • Persistent hypercalcemia, high levels of alkaline phosphatase, and parathyroid hormone were documented and a paratracheal mass was found on a helicoidal tomography of the thorax.
  • After surgical removal, the histopathological examination confirmed an ectopic adenoma of the parathyroid gland and the patient achieved some improvement in her clinical picture.
  • [MeSH-major] Adenoma / complications. Bone Diseases, Endocrine / etiology. Hyperparathyroidism, Primary / complications. Hyperparathyroidism, Primary / diagnosis. Parathyroid Neoplasms / complications
  • [MeSH-minor] Aged. Choristoma. Female. Fractures, Bone / etiology. Humans. Hypercalcemia / etiology. Nephrocalcinosis / etiology. Nephrolithiasis / etiology. Osteoporosis / etiology. Parathyroid Glands. Tracheal Diseases / etiology

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  • (PMID = 18824925.001).
  • [ISSN] 1536-7355
  • [Journal-full-title] Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases
  • [ISO-abbreviation] J Clin Rheumatol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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44. Yener S, Saklamaz A, Demir T, Kebapcilar L, Bayraktar F, Canda S, Yesil S: Primary hyperparathyroidism due to atypical parathyroid adenoma presenting with peroneus brevis tendon rupture. J Endocrinol Invest; 2007 May;30(5):442-4
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  • [Title] Primary hyperparathyroidism due to atypical parathyroid adenoma presenting with peroneus brevis tendon rupture.
  • [MeSH-major] Adenoma / complications. Hyperparathyroidism, Primary / etiology. Parathyroid Neoplasms / complications. Tendon Injuries / etiology

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  • (PMID = 17598980.001).
  • [ISSN] 1720-8386
  • [Journal-full-title] Journal of endocrinological investigation
  • [ISO-abbreviation] J. Endocrinol. Invest.
  • [Language] eng
  • [Publication-type] Case Reports; Letter
  • [Publication-country] Italy
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45. González VG, Orellana BP, Manuel López MJ, Jiménez MM, Quintana YJ: Early parathyroid MIBI SPECT imaging in the diagnosis of persistent hyperparathyroidism. Clin Nucl Med; 2008 Jul;33(7):475-8
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  • [Title] Early parathyroid MIBI SPECT imaging in the diagnosis of persistent hyperparathyroidism.
  • We present a case that demonstrates the utility of early SPECT images associated with fusion images with MRI for presurgical localization in a case of persistent hyperparathyroidism after a first surgery.
  • MRI and SPECT parathyroid scintigraphy showed an abnormal parathyroid lesion localized behind the inferior pole of the thyroid right lobe.
  • At surgical reexploration a right inferior parathyroid adenoma was removed (258 mg).
  • After that, the elevated PTH persisted and an ectopic parathyroid gland was identified in the tracheoesophageal groove (958 mg), corresponding with the lesion seen on the fusion image of MRI and SPECT.
  • [MeSH-major] Hyperparathyroidism / diagnosis. Hyperparathyroidism / radionuclide imaging. Parathyroid Glands / radionuclide imaging. Technetium Tc 99m Sestamibi. Tomography, Emission-Computed, Single-Photon / methods
  • [MeSH-minor] Humans. Hypercalcemia / diagnosis. Magnetic Resonance Imaging / methods. Male. Middle Aged. Parathyroid Hormone / biosynthesis. Parathyroid Neoplasms / complications. Parathyroid Neoplasms / surgery. Radionuclide Imaging / methods. Radiopharmaceuticals

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  • (PMID = 18580233.001).
  • [ISSN] 1536-0229
  • [Journal-full-title] Clinical nuclear medicine
  • [ISO-abbreviation] Clin Nucl Med
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Parathyroid Hormone; 0 / Radiopharmaceuticals; 971Z4W1S09 / Technetium Tc 99m Sestamibi
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46. Moncet D, Isaac G, Staltari D, Tomasello A, Boronat S: [Ectopic mediastinal parathyroid adenoma. Detection with a radioisotopic probe and resolution with videothoracoscopy]. Medicina (B Aires); 2006;66(5):457-60
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Ectopic mediastinal parathyroid adenoma. Detection with a radioisotopic probe and resolution with videothoracoscopy].
  • [Transliterated title] Adenoma paratiroideo ectópico mediastinal. Diagnóstico por sonda de detección gamma y resección por videotoracoscopia.
  • We report a 66 years old woman with a diagnosis of primary hyperparathyroidism.
  • Localization to mediastinum was obtained with parathyroid scintigraphy using 99mtc-methoxy-isobutyl-isonitrite (Tc99-MIBI).
  • An attempt to detect the precise site of the adenoma with a Tc99-MIBI probe was unsuccessful because of its proximity to the myocardium, but radioactivity was confirmed on the surgical specimen after resection.
  • [MeSH-major] Adenoma / radionuclide imaging. Hyperparathyroidism, Primary / radionuclide imaging. Mediastinal Neoplasms / radionuclide imaging. Parathyroid Neoplasms / radionuclide imaging. Radiopharmaceuticals. Technetium Tc 99m Sestamibi
  • [MeSH-minor] Aged. Calcium / blood. Calcium / urine. Female. Humans. Monitoring, Intraoperative / methods. Parathyroid Hormone / blood. Parathyroidectomy / methods. Preoperative Care. Sensitivity and Specificity. Thoracic Surgery, Video-Assisted / methods. Treatment Outcome

  • Hazardous Substances Data Bank. CALCIUM, ELEMENTAL .
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  • [ErratumIn] Medicina (B Aires). 2007;67(1):31
  • (PMID = 17137179.001).
  • [ISSN] 0025-7680
  • [Journal-full-title] Medicina
  • [ISO-abbreviation] Medicina (B Aires)
  • [Language] spa
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Argentina
  • [Chemical-registry-number] 0 / Parathyroid Hormone; 0 / Radiopharmaceuticals; 971Z4W1S09 / Technetium Tc 99m Sestamibi; SY7Q814VUP / Calcium
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47. Wiedmann M, Kassahun W, Deckert F, Tröltzsch M, Sturmvoll M, Führer D: [65-year old female patient with persistent hypercalcemia]. Internist (Berl); 2007 Dec;48(12):1436-41
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • A 65-year old patient presented with newly diagnosed hypercalcemia and elevated parathyroid hormone levels.
  • Exploration of parathyroid glands was performed under the diagnosis of primary hyperparathyroidism and was combined with thyreoidectomy due to concomittant multinodular goiter.
  • However, no parathyroid adenoma was identified despite careful exploration.
  • Therefore, the operation was terminated and an ectopic adenoma was suspected.
  • A (99m)Tc-sestamibi scintigraphy with SPECT, neck ultrasound, neck CT scan with contrast media and selective venous sampling were performed for further localization of the adenoma.
  • A single adenoma localized in the submandibular area of the left jaw was suspected and confirmed during surgical reexploration.
  • Postoperatively, parathyroid hormone levels were below detection level and the patient required short-term calcium supplementation for symptomatic hypocalcemia.
  • [MeSH-major] Adenoma / diagnosis. Choristoma / diagnosis. Hypercalcemia / etiology. Hyperparathyroidism, Primary / diagnosis. Parathyroid Neoplasms / diagnosis. Submandibular Gland Diseases / diagnosis
  • [MeSH-minor] Aged. Diagnosis, Differential. Female. Goiter, Nodular / diagnosis. Goiter, Nodular / pathology. Goiter, Nodular / surgery. Humans. Parathyroid Glands / pathology. Parathyroidectomy. Reoperation. Thyroid Gland / pathology. Thyroidectomy

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  • (PMID = 17965847.001).
  • [ISSN] 0020-9554
  • [Journal-full-title] Der Internist
  • [ISO-abbreviation] Internist (Berl)
  • [Language] ger
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Germany
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48. Hussain R, Zaman MU, Ahmed MN: LOCALIZATION OF A PARATHYROID ADENOMA IN A MULTI-NODULAR GOITER USING SESTAMIBI AND Tc-99m PERTECHNETATE SCANS. J Coll Physicians Surg Pak; 2007 Nov;17(11):712-3
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  • [Title] LOCALIZATION OF A PARATHYROID ADENOMA IN A MULTI-NODULAR GOITER USING SESTAMIBI AND Tc-99m PERTECHNETATE SCANS.

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  • (PMID = 18070589.001).
  • [ISSN] 1022-386X
  • [Journal-full-title] Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
  • [ISO-abbreviation] J Coll Physicians Surg Pak
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Pakistan
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49. Ogus M, Mayir B, Dinckan A: Mediastinal, cystic and functional parathyroid adenoma in patients with double parathyroid adenomas: a case report. Acta Chir Belg; 2006 Nov-Dec;106(6):736-8
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  • [Title] Mediastinal, cystic and functional parathyroid adenoma in patients with double parathyroid adenomas: a case report.
  • Primary hyperparathyroidism is usually caused by single adenoma.
  • Ectopic adenomas are a frequent cause of recurrent or persistent hyperparathyroidism.
  • Parathyroid cysts are rarely seen and most of them are non functional.
  • This case report describes a patient with double adenoma, one is solid and cervical, the other is cystic and located in mediastinum; both of them are functional.
  • [MeSH-major] Adenoma / pathology. Cystadenoma / pathology. Mediastinal Neoplasms / pathology. Parathyroid Neoplasms / pathology
  • [MeSH-minor] Aged. Female. Humans. Hyperparathyroidism, Primary / etiology

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  • (PMID = 17290712.001).
  • [ISSN] 0001-5458
  • [Journal-full-title] Acta chirurgica Belgica
  • [ISO-abbreviation] Acta Chir. Belg.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Belgium
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50. Elisei R, Romei C, Cosci B, Agate L, Bottici V, Molinaro E, Sculli M, Miccoli P, Basolo F, Grasso L, Pacini F, Pinchera A: RET genetic screening in patients with medullary thyroid cancer and their relatives: experience with 807 individuals at one center. J Clin Endocrinol Metab; 2007 Dec;92(12):4725-9
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  • Three different syndromes are distinguished: MEN 2A, when medullary thyroid carcinoma (MTC) is associated with pheochromocytoma and/or parathyroid adenomas; MEN 2B, when accompanied by a marfanoid habitus and/or pheochromocytoma; and familial medullary thyroid carcinoma (FMTC), when only MTC is present.


51. Aziz MM, Khan AW, Uddin MF, Hasanat MA, Kader MA, Chowdhury AJ, Choudhury NA: Endoscopic para-thyroidectomy: a new approach. Mymensingh Med J; 2010 Jul;19(3):442-6
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  • Two patients (one male and one female) underwent endoscopic para-thyroidectomy for parathyroid adenoma at the Department of Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.
  • Both patient's parathyroid hormone (PTH) level dropped to about one fourth the level in 12 to 20 minutes after enucleation (as compared to the immediate pre operative level).

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  • (PMID = 20639842.001).
  • [ISSN] 1022-4742
  • [Journal-full-title] Mymensingh medical journal : MMJ
  • [ISO-abbreviation] Mymensingh Med J
  • [Language] ENG
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Bangladesh
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52. Pereira FA, Brandão DF, Elias J Jr, Paula FJ: Parathyroid adenoma apoplexy as a temporary solution of primary hyperparathyroidism: a case report. J Med Case Rep; 2007;1:139
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  • [Title] Parathyroid adenoma apoplexy as a temporary solution of primary hyperparathyroidism: a case report.
  • INTRODUCTION: The natural history of patients with spontaneous parathyroid necrosis is unknown.
  • In this case report we describe the clinical course, laboratory, radiographic, bone densitometry tests, parathyroid ultrasonography and scintigraphy examinations of a patient performed over a period of eight years after she first presented with a sudden episode of spontaneous resolution of primary hyperparathyroidism (PHPT).
  • Biopsy of a cervical nodule revealed necrotic material compatible with ischemia of the parathyroid.
  • The second phase was characterized by normalization of calcium and parathyroid hormone levels and its end was difficult to define.
  • During the third phase there was a recurrence of hypercalcemia associated with elevated parathyroid hormone (PTH) levels and loss of bone mass.
  • CONCLUSION: This case report indicates that spontaneous resolution of PHPT by adenoma necrosis is potentially temporary.

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  • [Cites] QJM. 2000 Jun;93(6):365-7 [10873186.001]
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  • (PMID = 18021421.001).
  • [ISSN] 1752-1947
  • [Journal-full-title] Journal of medical case reports
  • [ISO-abbreviation] J Med Case Rep
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC2204027
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53. Adler JT, Chen H, Schaefer S, Sippel RS: Does routine use of ultrasound result in additional thyroid procedures in patients with primary hyperparathyroidism? J Am Coll Surg; 2010 Oct;211(4):536-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Does routine use of ultrasound result in additional thyroid procedures in patients with primary hyperparathyroidism?
  • BACKGROUND: Minimally invasive parathyroidectomy for primary hyperparathyroidism depends on accurate preoperative imaging.
  • Cervical ultrasound is commonly used to localize parathyroid adenomas, but can lead to discovery of concomitant thyroid gland pathology requiring modification of the operative approach.
  • RESULTS: Between July 2002 and November 2009, 310 patients with primary hyperparathyroidism underwent ultrasound.
  • Thirteen patients (4% of all patients) underwent a thyroid operation not related to parathyroid disease: 9 thyroid lobectomies for presumably benign nodules and 4 total thyroidectomies for malignancy.
  • CONCLUSIONS: Twenty-nine percent of patients with primary hyperparathyroidism had concomitant thyroid pathology on ultrasound.
  • Routine use of ultrasound in patients with primary hyperparathyroidism leads to discovery of unrecognized thyroid pathology and cancer.
  • [MeSH-major] Adenocarcinoma, Papillary / ultrasonography. Hyperparathyroidism, Primary / surgery. Hyperparathyroidism, Primary / ultrasonography. Thyroid Neoplasms / ultrasonography. Thyroid Nodule / pathology. Thyroidectomy
  • [MeSH-minor] Biopsy, Fine-Needle. Female. Humans. Incidental Findings. Male. Middle Aged. Reoperation. Thyroid Gland / ultrasonography. Treatment Outcome

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  • [Copyright] Copyright © 2010 American College of Surgeons. Published by Elsevier Inc. All rights reserved.
  • (PMID = 20822743.001).
  • [ISSN] 1879-1190
  • [Journal-full-title] Journal of the American College of Surgeons
  • [ISO-abbreviation] J. Am. Coll. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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54. Srivastava R, Jenkinson F, Murphy MJ: A rare case of metabolic bone disease. Ann Clin Biochem; 2007 Mar;44(Pt 2):192-5
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  • Biochemical abnormalities included hypercalcaemia, hypophosphataemia, raised alkaline phosphatase, raised parathyroid hormone and undetectable 25-hydroxy-vitamin D.
  • Bone biopsy was reported as consistent with a brown tumour of primary hyperparathyroidism and a sestamibi scan confirmed the presence of a parathyroid adenoma.
  • Coexistence of primary hyperparathyroidism and polyostotic fibrous dysplasia is very rare.
  • [MeSH-major] Bone Diseases, Metabolic / diagnosis. Bone and Bones / pathology. Fibrous Dysplasia, Polyostotic / diagnosis. Hyperparathyroidism / diagnosis
  • [MeSH-minor] Adult. Diagnosis, Differential. Female. Humans. Magnetic Resonance Imaging

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  • (PMID = 17362587.001).
  • [ISSN] 0004-5632
  • [Journal-full-title] Annals of clinical biochemistry
  • [ISO-abbreviation] Ann. Clin. Biochem.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
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55. Richards ML, Grant CS: Current applications of the intraoperative parathyroid hormone assay in parathyroid surgery. Am Surg; 2007 Apr;73(4):311-7
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  • [Title] Current applications of the intraoperative parathyroid hormone assay in parathyroid surgery.
  • Parathyroid hormone measurement using a two-site immunochemiluminometric assay has allowed for a rapid and accurate technique that has found its way into the operative armamentarium of some parathyroid surgeons.
  • It can be used to assess the completeness of parathyroid gland resection and allow for a minimally invasive parathyroidectomy.
  • The purpose of this review is to provide the surgeon with the practical points and pitfalls of the use of intraoperative parathyroid hormone in the treatment of parathyroid disease.
  • [MeSH-major] Luminescent Measurements / methods. Monitoring, Intraoperative / methods. Parathyroid Hormone / blood. Parathyroidectomy
  • [MeSH-minor] Adenoma / blood. Adenoma / surgery. Humans. Hyperparathyroidism / blood. Hyperparathyroidism / genetics. Hyperparathyroidism / surgery. Hyperparathyroidism, Secondary / blood. Hyperparathyroidism, Secondary / surgery. Minimally Invasive Surgical Procedures. Multiple Endocrine Neoplasia / blood. Multiple Endocrine Neoplasia / surgery. Parathyroid Neoplasms / blood. Parathyroid Neoplasms / surgery. Reoperation

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  • (PMID = 17439020.001).
  • [ISSN] 0003-1348
  • [Journal-full-title] The American surgeon
  • [ISO-abbreviation] Am Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Parathyroid Hormone
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56. Thongtang N, Plengvidhaya N, Lertwattnarak R, Peepatdit T: Primary hyperparathyroidism due to cystic parathyroid adenoma: a case report. J Med Assoc Thai; 2007 Nov;90 Suppl 2:79-84
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  • [Title] Primary hyperparathyroidism due to cystic parathyroid adenoma: a case report.
  • Raw Cystic parathyroid adenoma is a rare cause of primary hyperparathyroidism.
  • The authors report one case of cystic parathyroid adenoma, who presented with progressive right hip pain for one year.
  • Parathyroid hormone level was evaluated later and was found to be high, 1,555 pg/ml (15-65 pg/ml).
  • An MRI study of the neck was done and revealed a cystic mass 38 x 36 x 40 mm in diameter just below the left lower pole of the thyroid gland.
  • Hyperfunctioning parathyroid gland was considered.
  • Parathyroidectomy was done and histopathology revealed cystic parathyroid adenoma.
  • [MeSH-major] Cystadenoma / complications. Hyperparathyroidism, Primary / etiology. Parathyroid Hormone / blood. Parathyroid Neoplasms / complications

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  • (PMID = 19230428.001).
  • [ISSN] 0125-2208
  • [Journal-full-title] Journal of the Medical Association of Thailand = Chotmaihet thangphaet
  • [ISO-abbreviation] J Med Assoc Thai
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Thailand
  • [Chemical-registry-number] 0 / Parathyroid Hormone
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57. Pham TH, Sterioff S, Mullan BP, Wiseman GA, Sebo TJ, Grant CS: Sensitivity and utility of parathyroid scintigraphy in patients with primary versus secondary and tertiary hyperparathyroidism. World J Surg; 2006 Mar;30(3):327-32
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  • [Title] Sensitivity and utility of parathyroid scintigraphy in patients with primary versus secondary and tertiary hyperparathyroidism.
  • INTRODUCTION: Parathyroid scintigraphy (PS) may be used to localize hyperactive parathyroid glands preoperatively.
  • Performance of PS in the setting of secondary and tertiary hyperparathyroidism (HPT) is not well quantified.
  • The performance of PS in secondary/tertiary HPT versus primary HPT may reflect physiologic as well as radiopharmaceutical kinetic differences between multigland hyperplasia versus adenoma.
  • The aim of this study was to review the performance of PS in secondary/tertiary HPT with a comparison to that for primary HPT.
  • Moreover, we evaluated (1) the sensitivity of PS in detecting enlarged glands, and (2) PS detectability as a function of gland weight.
  • We identified 40 patients with secondary or tertiary HPT as well as a matched control group of 40 patients with primary HPT who had had preoperative PS and underwent parathyroid surgery.
  • RESULTS: Parathyroid scintigraphy correctly localized all enlarged glands in 88% of patients in the primary HPT group.
  • PS failed to identify one enlarged gland in 23% of the patients and two or more enlarged glands in 40% of the patients.
  • PS correctly detects the largest gland in 88% of the patients with secondary and tertiary HPT.
  • The mean gland weight detectable by PS was 612 +/- 120 mg for primary HPT.
  • CONCLUSIONS: Parathyroid scintigraphy is a sensitive study for localizing parathyroid glands preoperatively in primary HPT patients.
  • [MeSH-major] Hyperparathyroidism / diagnostic imaging. Tomography, Emission-Computed, Single-Photon
  • [MeSH-minor] Analysis of Variance. Case-Control Studies. Female. Humans. Iodine Radioisotopes. Male. Parathyroid Glands / diagnostic imaging. Parathyroid Glands / surgery. Radiopharmaceuticals. Retrospective Studies. Sensitivity and Specificity. Technetium Tc 99m Sestamibi

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58. Abshirini H, Rashidi I, Saki N: Pathologic fractures: a neglected clinical feature of parathyroid adenoma. Case Rep Med; 2010;2010:357029
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  • [Title] Pathologic fractures: a neglected clinical feature of parathyroid adenoma.
  • The pattern of clinical presentation of primary hyperparathyroidism (pHPT) has changed dramatically from a severe disease to an asymptomatic condition in Western countries.
  • Imaging and nuclear medicine studies will be helpful specially in patient who candidate for surgical removal of the abnormal parathyroid gland.
  • Here, we present a 48-year-old man with multiple typical fractures in long bones and a single adenoma in his right inferior parathyroid gland. pHPT is a severe, symptomatic disease with serious complications and high morbidity in Iran.

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  • [ISSN] 1687-9635
  • [Journal-full-title] Case reports in medicine
  • [ISO-abbreviation] Case Rep Med
  • [Language] eng
  • [Publication-type] Journal Article
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59. Alifano M, Parri SN, Arab WA, Bonfanti B, Lacava N, Porrello C, Boaron M: Limited upper sternotomy in general thoracic surgery. Surg Today; 2008;38(4):300-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • RESULTS: Thymus surgery represented the main indication for this approach (n = 51): for myasthenia without thymoma in 28 patients, for thymus neoplasms with or without myasthenia in 22, and for intrathymic parathyroid adenoma in 1.

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  • (PMID = 18368317.001).
  • [ISSN] 0941-1291
  • [Journal-full-title] Surgery today
  • [ISO-abbreviation] Surg. Today
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
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60. Takeshita T, Takeshita K, Abe S, Takami H, Imamura T, Furui S: Brown tumor with fluid-fluid levels in a patient with primary hyperparathyroidism: radiological findings. Radiat Med; 2006 Nov;24(9):631-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Brown tumor with fluid-fluid levels in a patient with primary hyperparathyroidism: radiological findings.
  • We report a case of a brown tumor with fluid-fluid levels in a patient with primary hyperparathyroidism.
  • The laboratory data showed elevated serum calcium and intact parathyroid hormone, confirming the diagnosis of primary hyperparathyroidism.
  • Histopathology of a biopsy specimen showed fibroblastic proliferation, abundant giant cells, and focal hemosiderin deposition, which supported the diagnosis of a brown tumor.
  • After removing the parathyroid adenoma, the brown tumor regressed and became sclerotic on radiographs.
  • [MeSH-major] Bone Neoplasms / diagnostic imaging. Giant Cell Tumor of Bone / diagnostic imaging. Hyperparathyroidism, Primary / complications

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  • (PMID = 17111272.001).
  • [ISSN] 0288-2043
  • [Journal-full-title] Radiation medicine
  • [ISO-abbreviation] Radiat Med
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] K2I13DR72L / Gadolinium DTPA
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61. Barczynski M, Konturek A, Cichon S, Hubalewska-Dydejczyk A, Golkowski F, Huszno B: Intraoperative parathyroid hormone assay improves outcomes of minimally invasive parathyroidectomy mainly in patients with a presumed solitary parathyroid adenoma and missing concordance of preoperative imaging. Clin Endocrinol (Oxf); 2007 Jun;66(6):878-85
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  • [Title] Intraoperative parathyroid hormone assay improves outcomes of minimally invasive parathyroidectomy mainly in patients with a presumed solitary parathyroid adenoma and missing concordance of preoperative imaging.
  • OBJECTIVE: Intraoperative parathyroid hormone assay (IOPTH) is often used during minimally invasive parathyroidectomy (MIP) for primary hyperparathyroidism (pHPT).
  • The aim of this study was to determine the impact of routine use of IOPTH on the success rate of MIP as the primary outcome, and whether it value-added to surgical decision-making during the operations at our institution.
  • The primary outcome was the cure rate, whereas the secondary outcome was the value-adding of IOPTH to surgical decision-making during MIP.
  • Five (8.1%) of the group 1 patients were hypercalcaemic postoperatively, owing to an additional, overlooked, hyperfunctioning parathyroid gland, whereas among the 115 group 2 patients, 104 (90.4%) underwent resection of a single parathyroid adenoma, met the Miami criterion, and were cured.
  • The remaining 11 (9.6%) patients did not have an adequate reduction in parathyroid hormone levels and underwent further neck exploration, with resection of additional hyperfunctioning parathyroids in nine of them.
  • However, a decrease of less than 50% of intraoperative parathyroid hormone (iPTH) assay correctly identified the risk of persistent disease in that patient.
  • It is a valuable adjunct in surgical decision-making, allowing for intraoperative recognition and resection of additional hyperfunctioning parathyroid tissue missed by preoperative imaging studies.
  • However, in patients with concordant results of two imaging studies, the assay offers significantly lower value-adding to surgical decisions, as a vast majority of patients are cured after removal of a two-image-indexed parathyroid lesion.
  • [MeSH-major] Adenoma / surgery. Monitoring, Intraoperative / methods. Parathyroid Hormone / blood. Parathyroid Neoplasms / surgery. Parathyroidectomy / methods. Thoracic Surgery, Video-Assisted
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Case-Control Studies. Chi-Square Distribution. Female. Follow-Up Studies. Humans. Hyperparathyroidism / blood. Male. Middle Aged. Prospective Studies. Treatment Outcome

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  • (PMID = 17437518.001).
  • [ISSN] 0300-0664
  • [Journal-full-title] Clinical endocrinology
  • [ISO-abbreviation] Clin. Endocrinol. (Oxf)
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / PTH protein, human; 0 / Parathyroid Hormone
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62. Ohata Y, Yamamoto T, Kitai Y, Mizoguchi Y, Iwaki M, Sumi K, Fujikawa Y, Koga M, Sugao H, Shimotsuji T, Ozono K: A case of primary hyperparathyroidism in childhood found by a chance hematuria. Clin Pediatr Endocrinol; 2007;16(1):11-6
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  • [Title] A case of primary hyperparathyroidism in childhood found by a chance hematuria.
  • Laboratory investigations revealed hypercalcemia, hypophosphatemia, and elevated serum levels of parathyroid hormone.
  • A parathyroid adenoma was successfully diagnosed with computed tomography, ultrasonography, and methoxy-2-isobutyl isonitrile (MIBI) scintigraphy.
  • Extracorporeal shock wave lithotripsy was performed to treat the urolithiasis, and the parathyroid adenoma was surgically removed.
  • Primary hyperparathyroidism is rare in childhood; however, this case suggests that gross hematuria is an important sign of hyperparathyroidism.

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  • (PMID = 24790339.001).
  • [ISSN] 0918-5739
  • [Journal-full-title] Clinical pediatric endocrinology : case reports and clinical investigations : official journal of the Japanese Society for Pediatric Endocrinology
  • [ISO-abbreviation] Clin Pediatr Endocrinol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Japan
  • [Other-IDs] NLM/ PMC4004894
  • [Keywords] NOTNLM ; bone mineral density / calcium / hematuria / hyperparathyroidism / phosphate
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63. Abboud B, Sleilaty G, Ayoub S, Hachem K, Smayra T, Ghorra C, Abadjian G: Intrathyroid parathyroid adenoma in primary hyperparathyroidism: can it be predicted preoperatively? World J Surg; 2007 Apr;31(4):817-23
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  • [Title] Intrathyroid parathyroid adenoma in primary hyperparathyroidism: can it be predicted preoperatively?
  • INTRODUCTION: The role of cervical ultrasonography (US)-guided surgery for intrathyroid parathyroid adenoma in primary hyperparathyroidism is rarely reported.
  • METHODS: From 1996 to 2003, cervical explorations were performed in 178 patients (mean age 57 years) with primary hyperparathyroidism.
  • Patients' characteristics were reviewed to identify predictive factors for intrathyroid adenoma.
  • RESULTS: Cervical US identified abnormal parathyroid glands in 163 of 178 patients, with a positive predictive value (PPV) of 100%.
  • Six patients (3.4%) were found to have intrathyroid parathyroid adenomas (two in the superior parathyroid and four in the inferior parathyroid).
  • Cervical US predicted this anomaly in four of six patients (67%) in whom the thyroid gland was not nodular and allowed total enucleation of the adenoma to be performed in three and subtotal thyroid loboisthmectomy in three; these operations were performed uneventfully and rapidly.
  • On multivariable analysis, no factor predicted intrathyroid localization of parathyroid adenoma.
  • CONCLUSIONS: The PPV of high-resolution cervical US for identifying an abnormal parathyroid gland was 100% in this series.
  • It was 80% for predicting intrathyroid localization of the adenoma.
  • This method allows us to shorten the operating time by guiding the exploration immediately toward the thyroid gland.
  • [MeSH-major] Hyperparathyroidism, Primary / etiology. Parathyroid Neoplasms / diagnostic imaging. Parathyroid Neoplasms / surgery

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  • (PMID = 17354026.001).
  • [ISSN] 0364-2313
  • [Journal-full-title] World journal of surgery
  • [ISO-abbreviation] World J Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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64. Nikou GC, Toubanakis C, Nikolaou P, Giannatou E, Marinou K, Safioleas M, Karamanolis D: Gastrinomas associated with MEN-1 syndrome: new insights for the diagnosis and management in a series of 11 patients. Hepatogastroenterology; 2005 Nov-Dec;52(66):1668-76
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  • [Title] Gastrinomas associated with MEN-1 syndrome: new insights for the diagnosis and management in a series of 11 patients.
  • The diagnosis of ZES was based upon: a) clinical features and b) high serum gastrin levels, while in 7/11 pts diagnosis was confirmed histopathologically.
  • All pts underwent conventional imaging methods (CT, MRI) and OCTREOSCAN or EUS when necessary, in order to localize the primary lesion or the metastases.
  • The diagnosis of MEN-1 was based upon the presence of the other two MEN-1 related endocrinopathies (hyperparathyroidism, pituitary adenomas), revealed by estimation of several hormones (PTH, Prolactin, ACTH etc.) and performance of imaging studies of the pituitary and parathyroid glands.
  • Serum gastrin levels at the time of diagnosis were greater than 1000pg/mL in 63.5% pts, while at the same time serum CgA levels were greater than 10 times the upper normal limit (<98ng/mL) in all pts.
  • OCTREOSCAN and EUS revealed the primary tumor (in duodenum or pancreas) in 64% pts, in whom conventional methods showed no abnormalities at the same time.
  • Parathyroid adenomas, pituitary adenomas and bronchial carcinoids were revealed in 11, 3 and 1 pts respectively, which were treated surgically.
  • Ten out of 11 pts are alive and in a good condition, whereas 1 patient died 2.8 years after diagnosis.
  • Familiar screening revealed parathyroid adenomas in 4 children of our pts, which were treated surgically.
  • [MeSH-major] Digestive System Neoplasms / diagnosis. Digestive System Neoplasms / therapy. Gastrinoma / diagnosis. Gastrinoma / therapy. Multiple Endocrine Neoplasia Type 1 / diagnosis. Multiple Endocrine Neoplasia Type 1 / therapy
  • [MeSH-minor] Adult. Aged. Combined Modality Therapy. Diagnostic Imaging / methods. Duodenal Neoplasms / complications. Duodenal Neoplasms / diagnosis. Duodenal Neoplasms / therapy. Endosonography / methods. Female. Follow-Up Studies. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Pancreatic Neoplasms / complications. Pancreatic Neoplasms / diagnosis. Pancreatic Neoplasms / therapy. Positron-Emission Tomography. Risk Assessment. Sampling Studies. Stomach Neoplasms / complications. Stomach Neoplasms / diagnosis. Stomach Neoplasms / therapy. Tomography, X-Ray Computed. Treatment Outcome

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  • (PMID = 16334754.001).
  • [ISSN] 0172-6390
  • [Journal-full-title] Hepato-gastroenterology
  • [ISO-abbreviation] Hepatogastroenterology
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Greece
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65. Niccoli-Sire P, Conte-Devolx B: [Multiple endocrine neoplasia type 2]. Ann Endocrinol (Paris); 2007 Oct;68(5):317-24
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Transliterated title] Néoplasies endocriniennes multiples de type 2.
  • Three phenotypic variants have been identified: MEN2A associates medullary thyroid carcinoma (MTC) to pheochromocytoma in about 20-50% of cases and to primary hyperparathyroidism in 5-20% of cases; MEN2B associates MTC to pheochromocytoma in 50% of cases, to marphanoid habitus and to mucosal and digestive ganglioneuromatosis whereas in familial isolated medullary thyroid carcinoma (FMTC), the other components of the disease are absent.
  • In MEN2, natural history of the disease and a common embryologic origin (neural crest) may explain the phenotypes observed in the organ involved, beginning from the stage of hyperplasia to adenoma and cancer.
  • MTC represent the most frequent circumstance of diagnosis.
  • Analysis of the RET gene allows to confirm the diagnosis of MEN2 by identifying the causal germline mutation.
  • Management of MEN2 patients include thyroidectomy associated to cervical central and bilateral lymph nodes dissection for MTC, unilateral adrenalectomy for unilateral pheochromocytoma or bilateral adrenalectomy when both glands are involved, and selective resection of pathologic parathyroid glands for HPT.
  • [MeSH-minor] Adrenal Gland Neoplasms / genetics. France / epidemiology. Genetic Variation. Humans. Hyperparathyroidism / genetics. Mutation. Pheochromocytoma / genetics. Prevalence. Proto-Oncogene Proteins c-ret / genetics

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  • (PMID = 17626779.001).
  • [ISSN] 0003-4266
  • [Journal-full-title] Annales d'endocrinologie
  • [ISO-abbreviation] Ann. Endocrinol. (Paris)
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Chemical-registry-number] EC 2.7.10.1 / Proto-Oncogene Proteins c-ret; EC 2.7.10.1 / RET protein, human
  • [Number-of-references] 56
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66. Orfanos NF, Mariolis-Sapsakos T, Orfanos FN, Goutas N, Vlachodimitropoulos D, Antoniou AG: Giant parathyroid adenoma with atypical ultrasonographic image. Clin Nucl Med; 2007 Mar;32(3):239-41
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Giant parathyroid adenoma with atypical ultrasonographic image.
  • [MeSH-major] Adenoma / radionuclide imaging. Adenoma / ultrasonography. Parathyroid Neoplasms / radionuclide imaging. Parathyroid Neoplasms / ultrasonography
  • [MeSH-minor] Diagnosis, Differential. Female. Humans. Middle Aged. Radiopharmaceuticals. Technetium Tc 99m Sestamibi

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  • (PMID = 17314610.001).
  • [ISSN] 0363-9762
  • [Journal-full-title] Clinical nuclear medicine
  • [ISO-abbreviation] Clin Nucl Med
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 971Z4W1S09 / Technetium Tc 99m Sestamibi
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67. Prasad B, Fleming RM: Intrathyroidal parathyroid adenoma. Clin Nucl Med; 2005 Jul;30(7):467-9
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  • [Title] Intrathyroidal parathyroid adenoma.
  • During surgery, the patient underwent a left thyroid lobectomy for an intrathyroidal parathyroid adenoma.
  • [MeSH-major] Adenoma / diagnosis. Adenoma / surgery. Hyperparathyroidism / diagnosis. Parathyroid Neoplasms / diagnosis. Parathyroid Neoplasms / surgery. Thyroid Neoplasms / diagnosis. Thyroid Neoplasms / surgery

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  • (PMID = 15965320.001).
  • [ISSN] 0363-9762
  • [Journal-full-title] Clinical nuclear medicine
  • [ISO-abbreviation] Clin Nucl Med
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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68. Chakravarti B, Dwivedi SK, Mithal A, Chattopadhyay N: Calcium-sensing receptor in cancer: good cop or bad cop? Endocrine; 2009 Jun;35(3):271-84
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • CaR plays a key role in the defense against hypercalcemia by "sensing" extracellular calcium levels in the parathyroid and kidney, the key organs maintaining systemic calcium homeostasis.
  • One situation is loss of CaR expression, resulting in loss of growth suppressing effects of elevated extracellular Ca(2+) by CaR, reported in parathyroid adenoma and in colon carcinoma.
  • Another situation is activation of CaR, resulting in increased production of parathyroid hormone-related peptide (PTHrP), a primary causal factor in hypercalcemia of malignancy and a contributor to metastatic processes involving bone.

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  • (PMID = 19011996.001).
  • [ISSN] 1355-008X
  • [Journal-full-title] Endocrine
  • [ISO-abbreviation] Endocrine
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Receptors, Calcium-Sensing
  • [Number-of-references] 203
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69. Turki ZM, Hajri H, Zrig N, Kourda N, Ferjaoui M, Ben Slama C: [Toxic nodular goitre associated with papillary thyroid carcinoma and primary hyperparathyroidism]. Rev Laryngol Otol Rhinol (Bord); 2006;127(4):239-42
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  • [Title] [Toxic nodular goitre associated with papillary thyroid carcinoma and primary hyperparathyroidism].
  • [Transliterated title] Association d'un goitre multinodulaire toxique, d'un carcinome papillaire de la thyroïde, et d'une hyperparathyroïdie primaire.
  • The association of a toxic multinodular goitre with papillary thyroid carcinoma and primary hyperparathyroidism is very rare.
  • The diagnosis of primary hyperparathyroidism was made following renal complications and the discovery of papillary thyroid carcinoma was incidental during the surgical treatment of parathyroid adenoma.
  • It is recognised that hyperparathyroidism can be found in hyperthyroid patients, but the diagnosis of hyperparathyroidism in these cases is very difficult.
  • The fortuitous discovery of papillary thyroid carcinoma during parathyroid surgery has already been reported but in most cases it is a microcarcinoma.
  • The association of primary hyperparathyroidism, hyperthyroidism and papillary carcinoma of the thyroid is rare.
  • [MeSH-minor] Female. Humans. Hyperparathyroidism, Primary / epidemiology. Hyperparathyroidism, Primary / pathology. Hyperparathyroidism, Primary / surgery. Middle Aged

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  • (PMID = 17315788.001).
  • [ISSN] 0035-1334
  • [Journal-full-title] Revue de laryngologie - otologie - rhinologie
  • [ISO-abbreviation] Rev Laryngol Otol Rhinol (Bord)
  • [Language] fre
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] France
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70. Starker LF, Delgado-Verdugo A, Udelsman R, Björklund P, Carling T: Expression and somatic mutations of SDHAF2 (SDH5), a novel endocrine tumor suppressor gene in parathyroid tumors of primary hyperparathyroidism. Endocrine; 2010 Dec;38(3):397-401
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  • [Title] Expression and somatic mutations of SDHAF2 (SDH5), a novel endocrine tumor suppressor gene in parathyroid tumors of primary hyperparathyroidism.
  • To investigate the SDHAF2 gene and its effect on primary hyperparathyroidism.
  • Parathyroid tumors causing primary hyperparathyroidism (pHPT) are one of the more common endocrine neoplasias.
  • Loss of heterozygosity at chromosome 11q13 is the most common chromosomal aberration in parathyroid tumors occurring in about 40% of sporadic tumors.
  • Only 15-19% display somatic mutations in the MEN1 gene, which suggest that this chromosomal region may harbor additional genes of importance in parathyroid tumor development.
  • We demonstrate that the SDHAF2 gene is expressed in parathyroid tissue using RT-PCR.
  • Because detection of inactivating mutations is the major criterion for validating a candidate tumor suppressor, we used automated sequencing of the coding region and intron/exon boundaries in 80 sporadic parathyroid adenomas from patients with pHPT.
  • A known polymorphisms (A to G substitution; rs879647) was identified in 9/80 parathyroid tumors but no tumor-specific somatic mutational aberrations, such as nonsense, frameshift, or other inactivating mutations were identified.
  • The SDHAF2 gene is expressed in parathyroid tissue.
  • However, somatic mutations of the SDHAF2 tumor suppressor gene are unlikely to frequently contribute to parathyroid tumor development in sporadic pHPT.
  • [MeSH-major] Hyperparathyroidism, Primary / genetics. Mitochondrial Proteins / genetics. Mutation. Neuroendocrine Tumors / genetics. Parathyroid Neoplasms / genetics

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  • (PMID = 20972721.001).
  • [ISSN] 1559-0100
  • [Journal-full-title] Endocrine
  • [ISO-abbreviation] Endocrine
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Mitochondrial Proteins; 0 / SDH5 protein, human
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71. Rubello D, Al-Nahhas A, Mariani G, Gross MD, Rampin L, Pelizzo MR: Feasibility and long-term results of focused radioguided parathyroidectomy using a "low" 37 MBq (1 mCi) 99mTc-sestamibi protocol. Int Semin Surg Oncol; 2006;3:30
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  • Aim of the present study was to investigate the feasibility and long-term results of focused radioguided parathyroidectomy using a "low" 37 MBq (1 mCi) 99mTc-sestamibi dose protocol compared to conventional "high 740 MBq (20 mCi) 99mTc-sestamibi dose protocol" in patients with primary hyperparathyroidism (PHPT).
  • The data of focused radioguided surgery obtained in a group of 320 consecutive PHPT patients with high probability of the presence of a solitary parathyroid adenoma (PA) were studied.
  • All patients underwent preoperative imaging work-up of double-tracer 99mTc-pertechnetate/99mTc-sestamibi subtraction parathyroid scintigraphy (Sestamibi scintigraphy) and high resolution neck ultrasound (US).
  • Focused low dose radioguided parathyroidectomy is a safe and effective means to localize parathyroid adenomas in patients affected by solitary PA thus reducing by 20 fold the radiation exposure dose to the patients and operating room personnel.

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  • (PMID = 16978398.001).
  • [ISSN] 1477-7800
  • [Journal-full-title] International seminars in surgical oncology : ISSO
  • [ISO-abbreviation] Int Semin Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC1584245
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72. Pieringer H, Hatzl-Griesenhofer M, Shebl O, Wiesinger-Eidenberger G, Maschek W, Biesenbach G: Hypocalcemic tetany in the newborn as a manifestation of unrecognized maternal primary hyperparathyroidism. Wien Klin Wochenschr; 2007;119(3-4):129-31
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  • [Title] Hypocalcemic tetany in the newborn as a manifestation of unrecognized maternal primary hyperparathyroidism.
  • Primary hyperparathyroidism (PHP) during pregnancy is a very rare event that increases maternal and perinatal morbidity and mortality.
  • Laboratory and radiological studies in the mother led to a diagnosis of maternal PHP.
  • An adenoma of the right lower parathyroid gland was subsequently removed.
  • [MeSH-major] Hyperparathyroidism, Primary / complications. Hyperparathyroidism, Primary / diagnosis. Hypocalcemia / congenital. Hypocalcemia / diagnosis. Pregnancy Complications / diagnosis. Tetany / congenital. Tetany / diagnosis

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  • (PMID = 17347863.001).
  • [ISSN] 0043-5325
  • [Journal-full-title] Wiener klinische Wochenschrift
  • [ISO-abbreviation] Wien. Klin. Wochenschr.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Austria
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73. Manning AT, O'Brien N, Kerin MJ: Roles for the calcium sensing receptor in primary and metastatic cancer. Eur J Surg Oncol; 2006 Sep;32(7):693-7
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  • [Title] Roles for the calcium sensing receptor in primary and metastatic cancer.
  • AIM: To review the role of the calcium sensing receptor (CASR) in colorectal, breast and parathyroid cancers and related cell lines, and to discuss the effects of CASR in the setting of bone metastases from breast cancer.
  • It is expressed in both normal and malignant breast tissues and has been implicated in the vicious cycle of bone metastases through its interactions with the parathyroid hormone related peptide (PTHrP).
  • In parathyroid tissue, CASR expression has been linked to proliferation of both parathyroid adenomas and carcinomas.
  • CASR has been shown to be involved in the progression and spread of a variety of cancers such as colorectal, breast and parathyroid, and is likely to be the focus of much research to further elucidate its precise role.
  • [MeSH-major] Bone Neoplasms / physiopathology. Bone Neoplasms / secondary. Breast Neoplasms / physiopathology. Colorectal Neoplasms / physiopathology. Parathyroid Neoplasms / physiopathology. Receptors, Calcium-Sensing / physiology
  • [MeSH-minor] Cell Line, Tumor. Female. Humans. Parathyroid Hormone-Related Protein / physiology. Signal Transduction / physiology


74. Sanz C, Vezzosi D, Pigny P, Bennet A, Caron P: Multiple endocrine neoplasia type 2a and germ line C634G RET mutation diagnosed in an 80-year-old patient. Ann Endocrinol (Paris); 2009 Apr;70(2):141-4
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  • Blood tests showed that serum calcium was increased (2.93 mmol/l, normal range 2.20-2.55 mmol/l) and serum concentration of intact parathyroid hormone (iPTH) inappropriately high (198 pg/ml, normal range 15-85 pg/ml).
  • Neck ultrasonography and Tc-MIBI scintigraphy revealed a right parathyroid adenoma and a multinodular goiter.
  • After right adrenalectomy which confirmed the diagnosis of pheochromocytoma, the patient underwent total thyroidectomy with dissection of the central lymph node compartment and right parathyroidectomy.
  • On histopathologic examination, both thyroid lobes presented 13 foci of MTC without lymph node metastasis and the parathyroid gland presented a benign adenoma without hyperplasia.
  • The diagnosis of Men2a at the age of 80 years and the absence of lymph node metastasis of the multiple MTC in a carrier of C634G mutation were unusual and argued for the possible role of genetic modifier(s) in this MEN 2a patient.
  • [MeSH-minor] Adenoma / radionuclide imaging. Adrenalectomy. Aged, 80 and over. Calcitonin / blood. Catecholamines / urine. Goiter, Nodular / ultrasonography. Humans. Male. Parathyroid Neoplasms / radionuclide imaging. Parathyroidectomy. Radiopharmaceuticals. Technetium Tc 99m Sestamibi. Thyroid Gland / radionuclide imaging. Thyrotropin / blood

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  • (PMID = 19201392.001).
  • [ISSN] 0003-4266
  • [Journal-full-title] Annales d'endocrinologie
  • [ISO-abbreviation] Ann. Endocrinol. (Paris)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Catecholamines; 0 / Radiopharmaceuticals; 9002-71-5 / Thyrotropin; 9007-12-9 / Calcitonin; 971Z4W1S09 / Technetium Tc 99m Sestamibi; EC 2.7.10.1 / Proto-Oncogene Proteins c-ret
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75. Liu PT, Johnson CD, Miranda R, Patel MD, Phillips CJ: A reference standard-based quality assurance program for radiology. J Am Coll Radiol; 2010 Jan;7(1):61-6
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  • The performance metrics tracked by the QA program include the accuracy of CT colonography for detecting polyps, the false-negative rate for mammographic detection of breast cancer, the accuracy of CT angiography detection of coronary artery stenosis, the accuracy of meniscal tear detection on MRI, the accuracy of carotid artery stenosis detection on MR angiography, the accuracy of parathyroid adenoma detection by parathyroid scintigraphy, the success rate for obtaining cortical tissue on ultrasound-guided core biopsies of pelvic renal transplants, and the technical success rate for peripheral arterial angioplasty procedures.

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  • [Copyright] Copyright 2010 American College of Radiology. Published by Elsevier Inc. All rights reserved.
  • (PMID = 20129274.001).
  • [ISSN] 1558-349X
  • [Journal-full-title] Journal of the American College of Radiology : JACR
  • [ISO-abbreviation] J Am Coll Radiol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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76. James R, England A: Preoperative localization of parathyroid adenomas: ultrasonography, sestamibi scintigraphy or both. Clin Otolaryngol; 2005 Aug;30(4):382-3; author reply 383
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  • [Title] Preoperative localization of parathyroid adenomas: ultrasonography, sestamibi scintigraphy or both.
  • [MeSH-major] Adenoma / ultrasonography. Parathyroid Neoplasms / ultrasonography. Preoperative Care

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  • [CommentIn] Clin Otolaryngol. 2006 Feb;31(1):82 [16441817.001]
  • [CommentOn] Clin Otolaryngol Allied Sci. 2004 Oct;29(5):549-52 [15373872.001]
  • (PMID = 16209695.001).
  • [ISSN] 1749-4478
  • [Journal-full-title] Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery
  • [ISO-abbreviation] Clin Otolaryngol
  • [Language] eng
  • [Publication-type] Comment; Letter
  • [Publication-country] England
  • [Chemical-registry-number] 971Z4W1S09 / Technetium Tc 99m Sestamibi
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77. Parfitt AM: Weight of normal parathyroid glands in patients with parathyroid adenomas. J Clin Endocrinol Metab; 2005 Jan;90(1):595; author reply 596
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  • [Title] Weight of normal parathyroid glands in patients with parathyroid adenomas.
  • [MeSH-major] Adenoma / pathology. Parathyroid Glands / pathology. Parathyroid Neoplasms / pathology

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  • [CommentOn] J Clin Endocrinol Metab. 2004 Jul;89(7):3208-13 [15240594.001]
  • (PMID = 15643025.001).
  • [ISSN] 0021-972X
  • [Journal-full-title] The Journal of clinical endocrinology and metabolism
  • [ISO-abbreviation] J. Clin. Endocrinol. Metab.
  • [Language] eng
  • [Publication-type] Comment; Letter
  • [Publication-country] United States
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78. Hamidi S, Soltani A, Hedayat A, Kamalian N: Primary hyperparathyroidism: a review of 177 cases. Med Sci Monit; 2006 Feb;12(2):CR86-9
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  • [Title] Primary hyperparathyroidism: a review of 177 cases.
  • BACKGROUND: We designed a comprehensive study to explore different aspects of primary hyperparathyroidism in a series of Iranian patients.
  • MATERIAL/METHODS: In a retrospective study from 1981 to 2003, we reviewed records of 177 patients operated on with the diagnosis of primary hyperparathyroidism in Shariati Hospital.
  • Patients with secondary or tertiary hyperparathyroidism and those being re-operated were excluded.
  • RESULTS: 88.1% of the lesions were adenoma, 9.6% hyperplasia, and 1 case proved to be carcinoma.
  • In 1.7% of patients, no pathologic gland(s) were found.
  • Patients with hyperplasia had lower calcium levels than patients with adenoma 24 hours post-operation, with mean calcium levels of 8.1+/-1.2 mg/dl versus 9.03+/-1.2 mg/dl, respectively (p=0.02).
  • Mean weight of adenomas was 4.1 gram (range 0.8-25 g).
  • Adenomas were mostly (74%) located in lower parathyroid glands and 6.3% of them were ectopic.
  • CONCLUSIONS: Primary hyperparathyroidism should be expected at younger ages in Iran.
  • Parathyroid hyperplasia in a patient should alert the surgeon of the higher risk of postoperative hypocalcemia.
  • [MeSH-major] Hyperparathyroidism, Primary / diagnosis
  • [MeSH-minor] Adenoma / pathology. Adolescent. Adult. Aged. Calcium / blood. Carcinoma / pathology. Female. Humans. Hyperplasia. Iran. Male. Middle Aged. Parathyroid Neoplasms / pathology. Retrospective Studies

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  • (PMID = 16449953.001).
  • [ISSN] 1234-1010
  • [Journal-full-title] Medical science monitor : international medical journal of experimental and clinical research
  • [ISO-abbreviation] Med. Sci. Monit.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Poland
  • [Chemical-registry-number] SY7Q814VUP / Calcium
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79. Sakurai K, Amano S, Enomoto K, Matsuo S, Kitajima A: Primary hyperparathyroidism with thyroid hemiagenesis. Asian J Surg; 2007 Apr;30(2):151-3
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  • [Title] Primary hyperparathyroidism with thyroid hemiagenesis.
  • We herein report a case with right thyroid lobe agenesis, which was incidentally found during the assessment of primary hyperparathyroidism.
  • A 42-year-old male presenting with urinary lithiasis was suspected of having primary hyperparathyroidism, and had elevated levels of both serum calcium and intact parathyroid hormone.
  • The patient underwent lower left parathyroidectomy, which confirmed the right thyroid hemiagenesis, as well as the absence of both upper and lower right parathyroid glands.
  • The resected left lower parathyroid gland was pathologically diagnosed as adenoma.

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  • (PMID = 17475589.001).
  • [ISSN] 1015-9584
  • [Journal-full-title] Asian journal of surgery
  • [ISO-abbreviation] Asian J Surg
  • [Language] ENG
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] China
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80. Espiritu RP, Dean DS: Parathyroidectomy-induced thyroiditis. Endocr Pract; 2010 Jul-Aug;16(4):656-9
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  • RESULTS: In 2 women (84 years old and 55 years old) with no history of thyroid disease in one of them and a remote history of excision of a follicular adenoma in the other, thyrotoxicosis developed a few days to a week after parathyroidectomy for primary hyperparathyroidism.
  • The first patient underwent bilateral cervical exploration with removal of a right inferior parathyroid adenoma, whereas the second patient had excision of 3 1/2 parathyroid glands for 4-gland hyperplasia and 2 benign nodules from the left thyroid lobe.
  • [MeSH-minor] Adrenergic beta-Antagonists / therapeutic use. Aged, 80 and over. Female. Humans. Hyperparathyroidism, Primary / surgery. Middle Aged. Postoperative Period. Thyroid Function Tests. Thyrotoxicosis / blood. Thyrotoxicosis / drug therapy. Thyrotoxicosis / epidemiology. Thyrotoxicosis / etiology

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  • (PMID = 20350919.001).
  • [ISSN] 1934-2403
  • [Journal-full-title] Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
  • [ISO-abbreviation] Endocr Pract
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Adrenergic beta-Antagonists
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81. Chudek J, Nagy A, Kokot F, Podwinski A, Wiecek A, Ritz E, Kovacs G: Phosphatemia is related to chromosomal aberrations of parathyroid glands in patients with hyperparathyroidism. J Nephrol; 2007 Mar-Apr;20(2):164-72
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  • [Title] Phosphatemia is related to chromosomal aberrations of parathyroid glands in patients with hyperparathyroidism.
  • BACKGROUND AND AIMS: It has been well documented that gene and DNA alterations occur frequently in benign primary parathyroid adenomas as well as in parathyroid glands with secondary hyperplasia.
  • METHODS: We analyzed the frequency of chromosomal aberrations in adenomas obtained from 25 patients with primary hyperparathyroidism (pHPT) and 60 parathyroid nodules from 20 uremic patients with secondary hyperparathyroidism (sHPT).
  • The relation of chromosomal aberrations to parathyroid hormone, as well as calcium and phosphate serum concentrations, was assessed.
  • RESULTS: Somatic chromosomal aberrations were found in 23 out of 25 adenomas, in hyperplastic lesions from 16 out of 20 patients.
  • CONCLUSION: Hyperphosphatemia may increase the risk of specific and random chromosomal aberrations due to increasing proliferation rate of parathyroid cells in patients with sHPT.
  • [MeSH-major] Chromosome Aberrations. Hyperparathyroidism / blood. Hyperparathyroidism / genetics. Parathyroid Glands / physiopathology. Phosphates / blood
  • [MeSH-minor] Adenoma / genetics. Adenoma / physiopathology. Adult. Aged. Alleles. Calcium / blood. Female. Humans. Hyperparathyroidism, Primary / blood. Hyperparathyroidism, Primary / genetics. Hyperparathyroidism, Secondary / blood. Hyperparathyroidism, Secondary / genetics. Male. Microsatellite Repeats. Middle Aged. Parathyroid Hormone / blood. Parathyroid Neoplasms / genetics

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  • (PMID = 17514620.001).
  • [ISSN] 1121-8428
  • [Journal-full-title] Journal of nephrology
  • [ISO-abbreviation] J. Nephrol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Italy
  • [Chemical-registry-number] 0 / Parathyroid Hormone; 0 / Phosphates; SY7Q814VUP / Calcium
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82. Mendoza PL, Ongkeko EE, Santiago JF: Silent parathyroid adenoma mistakenly interpreted on FDG-PET as thyroid cancer metastasis in a patient with elevated thyroglobulin and negative I-131 whole body scan and removed by radioguided minimally invasive surgery. Clin Nucl Med; 2008 Jan;33(1):23-5
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  • [Title] Silent parathyroid adenoma mistakenly interpreted on FDG-PET as thyroid cancer metastasis in a patient with elevated thyroglobulin and negative I-131 whole body scan and removed by radioguided minimally invasive surgery.
  • Histopathology, however, revealed a parathyroid adenoma.
  • [MeSH-major] Parathyroid Neoplasms / radionuclide imaging. Parathyroid Neoplasms / surgery. Thyroglobulin / blood. Tomography, Emission-Computed
  • [MeSH-minor] Diagnosis, Differential. Fluorodeoxyglucose F18. Humans. Iodine Radioisotopes. Male. Middle Aged. Minimally Invasive Surgical Procedures. Radiopharmaceuticals. Technetium Tc 99m Sestamibi. Thyroid Neoplasms / pathology. Thyroid Neoplasms / radionuclide imaging. Whole Body Imaging

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  • (PMID = 18097251.001).
  • [ISSN] 0363-9762
  • [Journal-full-title] Clinical nuclear medicine
  • [ISO-abbreviation] Clin Nucl Med
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Iodine Radioisotopes; 0 / Radiopharmaceuticals; 0Z5B2CJX4D / Fluorodeoxyglucose F18; 9010-34-8 / Thyroglobulin; 971Z4W1S09 / Technetium Tc 99m Sestamibi
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83. Mizumura Y, Mukaiyama Y, Osada H, Hida O, Nishimiya M, Nakamura Y: The reversed ratio of 1-84 PTH (whole PTH)/intact PTH in a patient on hemodialysis associated with primary hyperparathyroidism. Clin Nephrol; 2008 Apr;69(4):310-2
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  • [Title] The reversed ratio of 1-84 PTH (whole PTH)/intact PTH in a patient on hemodialysis associated with primary hyperparathyroidism.
  • He showed one enlarged parathyroid gland by an ultrasonic test, CT examination and RI subtraction study.
  • After this gland was removed by surgery, the ratio of whole PTH/intact PTH normalized.
  • The size of the resected gland was 22 x 15 x 11 mm.
  • The histologic examination revealed adenoma.
  • This indicates that, if patients with chronic renal failure showed the reversed ratio of whole PTH/intact PTH, the possibility that they could have primary hyperparathyroidism in addition to secondary hyperparathyroidism should be considered.
  • [MeSH-major] Hyperparathyroidism, Primary / blood. Parathyroid Hormone / blood. Renal Dialysis
  • [MeSH-minor] Adenoma / diagnosis. Humans. Kidney Failure, Chronic / therapy. Male. Middle Aged. Parathyroid Glands / surgery. Parathyroid Neoplasms / diagnosis. Parathyroidectomy


84. Gold JS, Donovan PI, Udelsman R: Partial median sternotomy: an attractive approach to mediastinal parathyroid disease. World J Surg; 2006 Jul;30(7):1234-9
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  • [Title] Partial median sternotomy: an attractive approach to mediastinal parathyroid disease.
  • BACKGROUND: Parathyroid exploration through a standard cervical approach is adequate for the resection of most mediastinal parathyroid glands.
  • A subset of mediastinal parathyroid glands causing hyperparathyroidism, however, cannot be removed in this manner.
  • RESULTS: Over a 14-year period, all but 10 of 937 (1.1%) consecutive patients explored for hyperparathyroidism by a single endocrine surgeon were treated by a cervical approach.
  • Six of these seven patients had failed a previous parathyroid exploration (86%), including one patient who had a previous complete sternotomy.
  • Cure of hyperparathyroidism was achieved in all seven patients undergoing partial median sternotomy.
  • In five patients a mediastinal parathyroid gland was removed (71%), and in one patient a parathyroid adenoma in the carotid sheath was eventually found, and the location of the hyperfunctioning parathyroid gland in one patient was never determined although the patient was cured.
  • CONCLUSIONS: Rarely, mediastinal parathyroid glands cannot be resected through a cervical approach.
  • In these cases the use of partial median sternotomy is an attractive technique in achieving cure of hyperparathyroidism and is associated with minimal morbidity and a short length of hospital stay.
  • [MeSH-major] Hyperparathyroidism / surgery. Mediastinal Diseases / surgery. Sternum / surgery

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  • (PMID = 16794907.001).
  • [ISSN] 0364-2313
  • [Journal-full-title] World journal of surgery
  • [ISO-abbreviation] World J Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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85. Lindstedt EW, van den Born LI, Veckeneer M, Baarsma GS: Sclerochoroidal calcification: idiopathic or associated with systemic disease? Retin Cases Brief Rep; 2007;1(3):141-4
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  • BACKGROUND: Idiopathic sclerochoroidal calcification is a rare disorder that may be confused with a malignant tumor.
  • METHODS: We report the case history of a patient with hypercalcemia and extensive sclerochoroidal calcifications; furthermore, we evaluate a series of seven patients with sclerochoroidal calcification, investigating calcium-phosphorus metabolism and screening for primary renal tubular hypokalemic metabolic alkalosis syndromes.
  • RESULTS: One patient was diagnosed with bilateral sclerochoroidal calcification; she had primary hyperparathyroidism due to a parathyroid adenoma.
  • None of the other seven patients met the criteria of primary renal tubular hypokalemic metabolic alkalosis syndromes or had significant problems of calcium-phosphorus metabolism.
  • CONCLUSION: For all patients with sclerochoroidal calcification, it is important to exclude primary renal tubular hypokalemic metabolic alkalosis syndromes such as Bartter and Gitelman syndromes, because these patients have a higher risk of cardiovascular morbidity especially during anesthesia.

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  • (PMID = 25390777.001).
  • [ISSN] 1935-1089
  • [Journal-full-title] Retinal cases & brief reports
  • [ISO-abbreviation] Retin Cases Brief Rep
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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86. Lazaris AC, Tseleni-Balafouta S, Papathomas T, Brousalis T, Thomopoulou G, Agrogiannis G, Patsouris ES: Immunohistochemical investigation of angiogenic factors in parathyroid proliferative lesions. Eur J Endocrinol; 2006 Jun;154(6):827-33
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  • [Title] Immunohistochemical investigation of angiogenic factors in parathyroid proliferative lesions.
  • OBJECTIVE: The pathological distinction between parathyroid neoplasms and hyperplasias remains difficult in several cases.
  • We attempted to examine whether immunohistochemical expression of CD105, VEGF and VEGF-R2 may be useful in distinguishing between parathyroid hyperplasia and neoplasia as well as to elucidate, to some extent, the mechanism of neovascularization in proliferative lesions of the parathyroid gland.
  • DESIGN: Tissue specimens were taken from 38 patients with primary hyperparathyroidism (HPT) (17 adenomas and 21 primary hyperplasias) and from 30 patients with secondary HPT.
  • RESULTS: Positive CD105 immunoreaction was significantly increased in parathyroid adenomas by comparison with primary hyperplasias (P = 0.033) and with secondary hyperplasias (P = 0.033).
  • When parathyroid adenomas, primary hyperplasia and secondary hyperplasia specimens were comparatively evaluated, VEGF immunoreaction was much more common in adenomas (P = 0.018).
  • In addition, in samples with secondary hyperplasia, VEGF-R2 immunoreactivity was positively linked with VEGF expression as well as with the apoptotic index of parathyroid cells (P = 0.038 and 0.010 respectively).
  • CONCLUSIONS: This study shows increased angiogenesis in parathyroid adenomas compared with parathyroid proliferative lesions.

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  • (PMID = 16728542.001).
  • [ISSN] 0804-4643
  • [Journal-full-title] European journal of endocrinology
  • [ISO-abbreviation] Eur. J. Endocrinol.
  • [Language] ENG
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antigens, CD; 0 / ENG protein, human; 0 / Receptors, Cell Surface; 0 / VEGFA protein, human; 0 / Vascular Endothelial Growth Factor A; EC 2.7.10.1 / Vascular Endothelial Growth Factor Receptor-2
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87. Kwak JY, Kim EK, Moon HJ, Kim MJ, Ahn SS, Son EJ, Sohn YM: Parathyroid incidentalomas detected on routine ultrasound-directed fine-needle aspiration biopsy in patients referred for thyroid nodules and the role of parathyroid hormone analysis in the samples. Thyroid; 2009 Jul;19(7):743-8
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  • [Title] Parathyroid incidentalomas detected on routine ultrasound-directed fine-needle aspiration biopsy in patients referred for thyroid nodules and the role of parathyroid hormone analysis in the samples.
  • BACKGROUND: The widespread use of high-resolution ultrasound (US) has allowed the detection of not only nonpalpable thyroid nodules but also parathyroid incidentalomas in the general population.
  • We sought to determine the prevalence of parathyroid incidentalomas in a large group of patients referred for US-guided fineneedle aspiration biopsy (FNAB) of suspected thyroid nodules and to investigate the role of additional parathyroid hormone (PTH) analysis in the washouts of FNAB of suspicious papathyroid nodules in these patients.
  • Among them, 112 patients (1.7%) underwent additional PTH analysis in FNAB washouts (FNA-PTH) due to suspected parathyroid lesions.
  • We evaluated the prevalence of parathyroid adenomas that were detected on thyroid US incidentally as well as the results of FNAB and FNA-PTH in parathyroid adenomas that were confirmed histopathologically.
  • RESULTS: Parathyroid incidentalomas were identified in 14 patients based on pathology and 10 patients based on elevated FNA-PTH.
  • The occurrence of parathyroid incidentalomas was 0.4% (24=6496) on thyroid US.
  • Four patients noticed symptoms related to hyperparathyroidism after FNA-PTH analysis.
  • CONCLUSIONS: The prevalence of parathyroid incidentaloma was 0.4% (24=6496) in a large series of patients referred for suspected thyroid nodules.
  • The use of FNA-PTH combined with FNAB can help clinicians accurately diagnose parathyroid incidentalomas at the time of US-guided FNAB.
  • [MeSH-major] Adenoma / ultrasonography. Biopsy, Fine-Needle. Parathyroid Hormone / analysis. Parathyroid Neoplasms / ultrasonography. Thyroid Nodule / ultrasonography
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Humans. Incidental Findings. Male. Middle Aged. Parathyroid Glands / ultrasonography. Prevalence. Retrospective Studies

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  • (PMID = 19593861.001).
  • [ISSN] 1557-9077
  • [Journal-full-title] Thyroid : official journal of the American Thyroid Association
  • [ISO-abbreviation] Thyroid
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / PTH protein, human; 0 / Parathyroid Hormone
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88. Elaraj DM, Sippel RS, Lindsay S, Sansano I, Duh QY, Clark OH, Kebebew E: Are additional localization studies and referral indicated for patients with primary hyperparathyroidism who have negative sestamibi scan results? Arch Surg; 2010 Jun;145(6):578-81
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  • [Title] Are additional localization studies and referral indicated for patients with primary hyperparathyroidism who have negative sestamibi scan results?
  • DESIGN, SETTING, AND PATIENTS: Prospective analysis of 492 operations for primary hyperparathyroidism from May 2005 to May 2007 at a tertiary care center.
  • Patients with positive sestamibi scan results compared with those with negative sestamibi scan results had a higher rate of single-gland disease (87% vs 63%, respectively) and lower rates of double adenoma (6% vs 22%, respectively) and asymmetric hyperplasia (7% vs 15%, respectively) (P<.001).
  • In patients with positive sestamibi scan results compared with those with negative sestamibi scan results, there was no significant difference in the rate of ectopic parathyroid glands (18% vs 12%, respectively) but there was a significant difference in cure rate (97% vs 89%, respectively) (P=.008).
  • CONCLUSIONS: Additional imaging with neck ultrasonography is helpful for selecting minimally invasive parathyroidectomy in most patients with primary hyperparathyroidism who have negative sestamibi scan results.
  • [MeSH-major] Diagnostic Imaging / methods. Hyperparathyroidism, Primary / diagnosis. Hyperparathyroidism, Primary / surgery. Parathyroidectomy / methods. Referral and Consultation / statistics & numerical data. Technetium Tc 99m Sestamibi
  • [MeSH-minor] Adult. Aged. Female. Follow-Up Studies. Humans. Male. Middle Aged. Minimally Invasive Surgical Procedures. Monitoring, Intraoperative / methods. Parathyroid Glands / radionuclide imaging. Parathyroid Glands / surgery. Parathyroid Glands / ultrasonography. Parathyroid Hormone / blood. Patient Selection. Preoperative Care / methods. Probability. Prospective Studies. Risk Assessment. Sensitivity and Specificity. Severity of Illness Index. Treatment Outcome. Ultrasonography, Doppler

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  • (PMID = 20566979.001).
  • [ISSN] 1538-3644
  • [Journal-full-title] Archives of surgery (Chicago, Ill. : 1960)
  • [ISO-abbreviation] Arch Surg
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Parathyroid Hormone; 971Z4W1S09 / Technetium Tc 99m Sestamibi
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89. Abbas F, Biyabani SR, Memon A, Talati J: Mediastinal parathyroid adenoma causing primary hyperparathyroidism. J Pak Med Assoc; 2007 Feb;57(2):93-5
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  • [Title] Mediastinal parathyroid adenoma causing primary hyperparathyroidism.
  • An ectopically placed parathyroid adenoma in the anterior mediastinum is a rare cause of persistent or recurrent primary hyperparathyroidism (PHPT) and is recognized as an important cause of failed primary neck exploration.
  • In 2 cases, the offending adenoma could be removed at first exploration whereas in the 3rd case, it was successfully removed with mediastinal exploration after 2 failed neck explorations.
  • In established cases of PHPT with equivocal preoperative localization studies or negative neck explorations, an ectopically placed parathyroid adenoma should be considered and once localized, should be surgically removed for cure.
  • [MeSH-major] Adenoma / pathology. Hyperparathyroidism, Primary / etiology. Parathyroid Neoplasms / pathology. Thymus Neoplasms / pathology

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  • (PMID = 17370794.001).
  • [ISSN] 0030-9982
  • [Journal-full-title] JPMA. The Journal of the Pakistan Medical Association
  • [ISO-abbreviation] J Pak Med Assoc
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Pakistan
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90. Portela-Gomes GM, Grimelius L, Wilander E, Stridsberg M: Granins and granin-related peptides in neuroendocrine tumours. Regul Pept; 2010 Nov 30;165(1):12-20
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  • SgIII has recently arisen as an important NET marker; it was strongly expressed in NETs, with some exceptions--phaeochromocytomas expressed few cells and parathyroid adenomas none.

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  • [Copyright] Copyright © 2010 Elsevier B.V. All rights reserved.
  • (PMID = 20211659.001).
  • [ISSN] 1873-1686
  • [Journal-full-title] Regulatory peptides
  • [ISO-abbreviation] Regul. Pept.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Netherlands
  • [Chemical-registry-number] 0 / Chromogranin A; 0 / Chromogranin B; 0 / Chromogranins; 0 / Neuropeptides; 0 / Secretogranin II; 149146-12-3 / secretoneurin
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91. Johnson NA, Yip L, Tublin ME: Cystic parathyroid adenoma: sonographic features and correlation with 99mTc-sestamibi SPECT findings. AJR Am J Roentgenol; 2010 Dec;195(6):1385-90
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  • [Title] Cystic parathyroid adenoma: sonographic features and correlation with 99mTc-sestamibi SPECT findings.
  • OBJECTIVE: The purpose of this study was to describe the typical ultrasound features of cystic parathyroid adenoma.
  • MATERIALS AND METHODS: A review of a surgical database and electronic medical records from 2006 to 2009 identified the cases of 15 patients who underwent preoperative cervical sonography for primary hyperparathyroidism with subsequent resection of pathologically proven parathyroid adenoma with predominantly cystic components.
  • Technetium-99m-sestamibi SPECT findings, surgical and pathologic reports, and the results of parathyroid hormone assay of the cyst fluid also were reviewed.
  • RESULTS: Most of the cystic adenomas (14/15, 93%) were deep or inferolateral to the adjacent thyroid.
  • An echogenic border separating the adenoma from the overlying thyroid was identified in 9 of 15 patients (60%).
  • Six of 14 patients underwent preoperative or intraoperative sampling of cyst fluid, and the assay showed the parathyroid hormone levels ranged from 1,198 to greater than 5,000 pg/mL.
  • Fourteen of 15 patients underwent preoperative sestamibi SPECT, and the adenoma was definitively localized in four patients (29%).
  • CONCLUSION: Awareness of typical sonographic features (location, color Doppler vascularity) may aid radiologists in preoperative localization of parathyroid adenomas, even when cystic degeneration occurs.
  • In cases in which imaging or clinical features are equivocal, the results of cyst fluid sampling and parathyroid hormone assay are confirmatory.
  • [MeSH-major] Adenoma / radionuclide imaging. Adenoma / ultrasonography. Parathyroid Neoplasms / radionuclide imaging. Parathyroid Neoplasms / ultrasonography. Tomography, Emission-Computed, Single-Photon. Ultrasonography, Doppler, Color
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Humans. Hyperparathyroidism, Primary / etiology. Male. Middle Aged. Radiopharmaceuticals. Retrospective Studies. Technetium Tc 99m Sestamibi

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  • (PMID = 21098199.001).
  • [ISSN] 1546-3141
  • [Journal-full-title] AJR. American journal of roentgenology
  • [ISO-abbreviation] AJR Am J Roentgenol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 971Z4W1S09 / Technetium Tc 99m Sestamibi
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92. Derreberry T, Yaqub A: Parathyroid FNA and hormone assay. W V Med J; 2009 Sep-Oct;105(5):30-4
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  • [Title] Parathyroid FNA and hormone assay.
  • Primary hyperparathyroidism is a relatively common problem encountered in clinical endocrine practice.
  • In most cases the diagnosis is relatively straightforward, however, when imaging studies fail to localize the parathyroid adenoma or hyperplasia, management can be challenging.
  • We describe here such a case where the diagnosis was made by a novel method of analysis of parathyroid hormone levels in the needle wash obtained during fine-needle aspiration of a suspected parathyroid adenoma.
  • His parathyroid hormone level was within normal limits.
  • He was started on hydrochlorthiazide therapy for a presumptive diagnosis of idiopathic hypercalciuria.
  • Parathyroid hormone level remained in mid-normal range.
  • A diagnosis of primary hyperparathyroidism was considered at this stage and imaging studies were carried out to localize the parathyroid pathology.
  • Parathyroid-sestamibi scan did not reveal any abnormality.
  • A fine needle aspiration of the nodule was carried out with estimation of parathyroid hormone level in the needle wash to indicate the presence of parathyroid adenoma.
  • The current management of hyperparathyroidism is primarily surgical.
  • Minimally invasive parathyroid surgery is the treatment of choice but it requires the clear localization of a parathyroid lesion for successful removal.
  • In cases where preoperative localization is evasive, novel techniques, such as the one described above, can provide useful diagnostic information which can aid in the successful management of hyperparathyroidism.
  • [MeSH-major] Adenoma / pathology. Parathyroid Hormone / analysis. Parathyroid Neoplasms / pathology

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  • (PMID = 19806869.001).
  • [ISSN] 0043-3284
  • [Journal-full-title] The West Virginia medical journal
  • [ISO-abbreviation] W V Med J
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Parathyroid Hormone
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93. Soby K, Gupta JD, Neitzschman HR: Radiology case of the month. 99mTc sestamibi scintigraphy definitively determines the cause of hypercalcemia. Primary hyperparathyroidism secondary to parathyroid adenoma. J La State Med Soc; 2010 Sep-Oct;162(5):257-9
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  • [Title] Radiology case of the month. 99mTc sestamibi scintigraphy definitively determines the cause of hypercalcemia. Primary hyperparathyroidism secondary to parathyroid adenoma.
  • [MeSH-major] Adenoma / complications. Adenoma / radionuclide imaging. Hypercalcemia / etiology. Hyperparathyroidism, Primary / etiology. Parathyroid Neoplasms / complications. Parathyroid Neoplasms / radionuclide imaging. Technetium Tc 99m Sestamibi

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  • (PMID = 21141256.001).
  • [ISSN] 0024-6921
  • [Journal-full-title] The Journal of the Louisiana State Medical Society : official organ of the Louisiana State Medical Society
  • [ISO-abbreviation] J La State Med Soc
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 971Z4W1S09 / Technetium Tc 99m Sestamibi
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94. Birdas TJ, Keenan RJ: Mediastinal parathyroid adenoma. Ann Thorac Surg; 2005 Mar;79(3):1097
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  • [Title] Mediastinal parathyroid adenoma.
  • [MeSH-major] Adenoma. Choristoma. Mediastinal Neoplasms. Parathyroid Neoplasms

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  • [CommentOn] Ann Thorac Surg. 2004 Feb;77(2):724 [14759477.001]
  • (PMID = 15734465.001).
  • [ISSN] 1552-6259
  • [Journal-full-title] The Annals of thoracic surgery
  • [ISO-abbreviation] Ann. Thorac. Surg.
  • [Language] eng
  • [Publication-type] Case Reports; Comment; Letter
  • [Publication-country] Netherlands
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95. Riss P, Asari R, Scheuba C, Bieglmayer C, Niederle B: PTH secretion of "manipulated" parathyroid adenomas. Langenbecks Arch Surg; 2009 Sep;394(5):891-5
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  • [Title] PTH secretion of "manipulated" parathyroid adenomas.
  • PURPOSE: Increased secretion of parathyroid hormone (PTH) and its fragments intraoperatively may influence PTH monitoring.
  • The purpose of this study was to investigate whether "intended intraoperative manipulation" of parathyroid adenomas through mechanical stimulation (through squeezing or manual rubbing) would lead to increased PTH excretion.
  • METHODS: The enlarged glands of six consecutive patients who underwent open minimally invasive parathyroid exploration were "manipulated" for 30 s as soon as they had been identified.
  • RESULTS: An increased PTH secretion was documented in four of six "manipulated" single adenomas (mean PTH +/- SD 312 +/- 497 pg/ml).
  • CONCLUSIONS: First, secretion of PTH varies widely after manual manipulation of adenomas.
  • [MeSH-major] Adenoma / surgery. Parathyroid Hormone / secretion. Parathyroid Neoplasms / surgery. Parathyroidectomy

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  • [Cites] Arch Surg. 2006 Feb;141(2):129-34; discussion 134 [16490888.001]
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  • (PMID = 19396458.001).
  • [ISSN] 1435-2451
  • [Journal-full-title] Langenbeck's archives of surgery
  • [ISO-abbreviation] Langenbecks Arch Surg
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Parathyroid Hormone
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96. Lazar HL, Oates E, Beazley RM: Excision of a mediastinal parathyroid adenoma after coronary artery bypass surgery. Ann Thorac Surg; 2005 Sep;80(3):1105-6
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  • [Title] Excision of a mediastinal parathyroid adenoma after coronary artery bypass surgery.
  • In this report we describe the removal of a mediastinal parathyroid adenoma in a patient who had two previous coronary artery bypass graft procedures.
  • The surgical approach and intraoperative localization of the adenoma under these unusual circumstances are reviewed.
  • [MeSH-major] Adenoma / surgery. Mediastinal Neoplasms / surgery. Parathyroid Neoplasms / surgery

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  • (PMID = 16122500.001).
  • [ISSN] 1552-6259
  • [Journal-full-title] The Annals of thoracic surgery
  • [ISO-abbreviation] Ann. Thorac. Surg.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Netherlands
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97. Juhlin CC, Haglund F, Villablanca A, Forsberg L, Sandelin K, Bränström R, Larsson C, Höög A: Loss of expression for the Wnt pathway components adenomatous polyposis coli and glycogen synthase kinase 3-beta in parathyroid carcinomas. Int J Oncol; 2009 Feb;34(2):481-92
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  • [Title] Loss of expression for the Wnt pathway components adenomatous polyposis coli and glycogen synthase kinase 3-beta in parathyroid carcinomas.
  • The development of parathyroid carcinoma has been associated with inactivating mutations of the Hyperparathyroidism type 2 (HRPT2) gene encoding parafibromin, a member of the human RNA Polymerase II-Associated Factor Complex (hPAF) and functionally linked to the Wingless type (Wnt) pathway.
  • In this study, we characterized the expression of Wnt pathway molecules in parathyroid benign and malignant tumors.
  • The study comprised 13 tumors from 12 cases of unequivocal parathyroid carcinoma, 18 cases of parathyroid adenoma, as well as non-tumorous parathyroid tissue.
  • Adenomatous polyposis coli (APC) was uniformly expressed in non-tumorous parathyroid tissue and adenomas, but absent in carcinomas from 9 of 12 patients (75%).
  • Expression of glycogen synthase kinase 3-beta (GSK3-beta) was lost in 4/12 carcinomas and in 1/18 adenomas.
  • Loss of APC immunoreactivity was significantly associated with parathyroid carcinoma as compared to adenomas (p<0.001), giving a high specificity (100%) and sensitivity (75%) for the detection of parathyroid malignancy.
  • The results suggest the involvement of Wnt-pathway members APC and GSK3-beta in parathyroid carcinoma development.
  • In addition, APC immunohistochemistry could become a useful tool for improved recognition of parathyroid carcinoma together with immunohistochemistry for parafibromin and proliferation index.
  • [MeSH-major] Adenomatous Polyposis Coli / genetics. Glycogen Synthase Kinase 3 / genetics. Parathyroid Neoplasms / enzymology. Parathyroid Neoplasms / genetics. Wnt Proteins / genetics
  • [MeSH-minor] Adenoma / enzymology. Adenoma / genetics. Adult. Aged. Carcinoma / enzymology. Carcinoma / genetics. Female. Gene Expression Regulation, Neoplastic. Humans. Male. Middle Aged. Neoplasm Metastasis / genetics. Sensitivity and Specificity


98. Bergero N, De Pompa R, Sacerdote C, Gasparri G, Volante M, Bussolati G, Papotti M: Galectin-3 expression in parathyroid carcinoma: immunohistochemical study of 26 cases. Hum Pathol; 2005 Aug;36(8):908-14
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  • [Title] Galectin-3 expression in parathyroid carcinoma: immunohistochemical study of 26 cases.
  • The diagnosis of parathyroid carcinoma (PC) is difficult and based on morphological features that are not totally reliable.
  • With the aim of identifying a marker of malignancy in parathyroid tumors, we tested the expression of galectin-3 (Gal-3), a lectin expressed in several malignant tumors, including follicular carcinomas (but not adenomas) of the thyroid.
  • Twenty-six PCs and 30 control parathyroid adenomas (PAs) were collected.
  • All cases were immunohistochemically tested for Gal-3 and for other markers claimed to be useful in the differential diagnosis of parathyroid neoplasms, namely, Ki67, p27, and bcl2.
  • We conclude that Gal-3 immunostaining is a valuable tool to support a diagnosis of PC in highly proliferating (Ki67 >6%) tumors affecting a single parathyroid gland.
  • [MeSH-major] Biomarkers, Tumor / analysis. Galectin 3 / biosynthesis. Parathyroid Neoplasms / metabolism. Parathyroid Neoplasms / pathology
  • [MeSH-minor] Adenoma / metabolism. Adenoma / pathology. Adult. Aged. Carcinoma / metabolism. Carcinoma / pathology. Diagnosis, Differential. Female. Humans. Immunohistochemistry. Ki-67 Antigen / metabolism. Male. Middle Aged. Sensitivity and Specificity

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  • (PMID = 16112008.001).
  • [ISSN] 0046-8177
  • [Journal-full-title] Human pathology
  • [ISO-abbreviation] Hum. Pathol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Galectin 3; 0 / Ki-67 Antigen
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99. Friedman M, Gurpinar B, Schalch P, Joseph NJ: Guidelines for radioguided parathyroid surgery. Arch Otolaryngol Head Neck Surg; 2007 Dec;133(12):1235-9
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  • [Title] Guidelines for radioguided parathyroid surgery.
  • OBJECTIVE: To confirm or refute the notion that only parathyroid adenomas have radioactivity higher than 20% of background.
  • PATIENTS: Forty-six patients (9 men and 37 women; mean +/- SD age, 53.7 +/- 12.1 years) underwent thyroid and parathyroid surgery between December 2005 and December 2006 to collect data on ex vivo radioactivity percentages on a variety of tissues.
  • Biopsy specimens were taken of normal parathyroid glands, normal thyroid tissue, and lymph nodes and ex vivo radioactivity was recorded.
  • Hyperplastic parathyroid glands and adenomatous glands were excised.
  • RESULTS: The mean +/- SD ex vivo background radioactivity of parathyroid adenomas was 148.5% +/- 83.1% of background activity (range, 40.1%-388.9% but never less than 40%).
  • The mean +/- SD ex vivo background radioactivity of hyperplastic parathyroid glands was 74.6% +/- 18.0% (range, 49.5%-109.1% but never less than 40%).
  • A significant difference was found in ex vivo background radioactivity between pathologic parathyroid tissue and the other tissue specimens studied (normal parathyroid glands [2.4% +/- 1.8%], thyroid tissue [4.5% +/- 2.8%], lymph nodes [1.6% +/- 0.8%], and fat [0.4% +/- 0.3%]).
  • CONCLUSIONS: Ex vivo radioactivity percentages can differentiate hyperactive parathyroid tissue from any other tissue, but they cannot differentiate adenoma from hyperplasia and thus are not helpful in ruling out multiglandular disease.
  • [MeSH-major] Adenoma / surgery. Parathyroid Neoplasms / surgery. Parathyroidectomy / methods. Practice Guidelines as Topic. Technetium Tc 99m Sestamibi. Tomography, Emission-Computed, Single-Photon / methods

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  • (PMID = 18086965.001).
  • [ISSN] 0886-4470
  • [Journal-full-title] Archives of otolaryngology--head & neck surgery
  • [ISO-abbreviation] Arch. Otolaryngol. Head Neck Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Radiopharmaceuticals; 971Z4W1S09 / Technetium Tc 99m Sestamibi
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100. Karakousis GC, Han D, Kelz RR, Nemani D, Karamacharya J, Roses R, Gimotty PA, Fraker DL: Interpretation of intra-operative PTH changes in patients with multi-glandular primary hyperparathyroidism (pHPT). Surgery; 2007 Dec;142(6):845-50; discussion 850.e1-2
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  • [Title] Interpretation of intra-operative PTH changes in patients with multi-glandular primary hyperparathyroidism (pHPT).
  • BACKGROUND: The correct interpretation of intraoperative parathyroid hormone (IOPTH) levels in patients with primary hyperparathyroid patients (pHPT) with multiglandular disease (MGD) can impact the success rate of initial parathyroid exploration, but it remains an understudied topic.
  • We investigated the incidence of MGD in patients with an appreciable (>50%) decrease in IOPTH levels and in patients whose levels failed to normalize after single gland excision.
  • Thirty-one patients had PTH levels that decreased by greater than 50% from baseline 10-15 min after single gland excision, but the levels failed to normalize.
  • Of these, 9 patients (29%) had MGD (8 double adenomas, 1 hyperplasia).
  • Within the subgroup of 31 patients, those with single adenomas did not differ from patients with MGD in baseline IOPTH levels and weights of first adenoma excised, although they demonstrated greater serum creatinine concentrations and a decrease in mean IOPTH.
  • CONCLUSION: Commonly accepted decreases in IOPTH levels (>50%) for patients who undergo minimally invasive parathyroidectomy may lead to an appreciable number of missed parathyroid adenomas or hyperplastic disease.
  • [MeSH-major] Monitoring, Intraoperative. Multiple Endocrine Neoplasia / blood. Multiple Endocrine Neoplasia / surgery. Parathyroid Hormone / blood. Parathyroidectomy
  • [MeSH-minor] Adenoma / blood. Adenoma / epidemiology. Adenoma / surgery. Adult. Aged. Female. Humans. Hyperparathyroidism / blood. Hyperparathyroidism / epidemiology. Hyperparathyroidism / surgery. Incidence. Male. Middle Aged. Minimally Invasive Surgical Procedures. Parathyroid Neoplasms / blood. Parathyroid Neoplasms / epidemiology. Parathyroid Neoplasms / surgery

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  • [ErratumIn] Surgery. 2008 Feb;143(2):302
  • (PMID = 18063066.001).
  • [ISSN] 1532-7361
  • [Journal-full-title] Surgery
  • [ISO-abbreviation] Surgery
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Parathyroid Hormone
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