1/59. amyloid goiter with parathyroid involvement: a case report and review of the literature.Although involvement of the thyroid gland by amyloid is a relatively common phenomenon, diffuse enlargement of the gland secondary to infiltration by amyloid is infrequent. We report the pathologic findings in a case of primary amyloid goiter with involvement of a parathyroid gland in an euthyroid patient who presented to his physician with an enlarged thyroid, upper airway obstructive symptoms, and dysphagia. The clinical features of amyloid goiter, including difficulties in preoperative diagnosis and management, are discussed.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
2/59. Langerhans cell histiocytosis involving the thyroid and parathyroid glands.Langerhans cell histiocytosis (LCH) is a rare illness, and the disease afflicting the thyroid gland is very uncommon, even in the presence of multisystem involvement. In this report, we document histologically, for the first time, concurrent involvement of the thyroid and parathyroid glands by LCH. A young Chinese woman with a history of diabetes insipidus and hypogonadism underwent a total thyroidectomy for enlarged thyroid gland secondary to LCH causing airway obstruction. Microscopic examination of the excised specimen disclosed CD1a- and S-100-positive LCH cells involving the thyroid and parathyroid glands. In a patient with LCH affecting the thyroid gland, parathyroid gland disease should be suspected when the serum calcium levels are depressed in association with an inappropriate serum parathyroid hormone level, such as a normal parathyroid hormone level in this case.- - - - - - - - - - ranking = 3.3333333333333keywords = gland (Clic here for more details about this article) |
3/59. Acute extracapsular parathyroid hemorrhage: case report and review of the literature.OBJECTIVE: To describe a patient with extracapsular parathyroid hemorrhage and review the signs and symptoms of this condition. methods: We report a case of extracapsular parathyroid hemorrhage in a patient with primary hyperparathyroidism and present an overview of previously reported cases. RESULTS: A 48-year-old woman with documented primary hyperparathyroidism, who was awaiting surgical intervention, had acute onset of a neck mass, neck pain, and dysphagia. She was found to have sustained a spontaneous extracapsular hemorrhage of a parathyroid adenoma. hypercalcemia persisted, and she subsequently underwent curative parathyroidectomy for the primary hyperparathyroidism. We also identified 15 previously reported cases of extracapsular parathyroid hemorrhage and summarized the most common manifestations-most notably, a neck mass or swelling, ecchymoses of the neck and chest, dysphagia, neck pain, hoarseness, and dyspnea. CONCLUSION: Clinicians should be aware of the potential for occurrence of extracapsular parathyroid hemorrhage in patients with primary hyperparathyroidism. When this condition occurs, severe hypercalcemia or acute hypocalcemia may be present. hypercalcemia is often persistent; however, autoinfarction of the parathyroid adenoma is possible.- - - - - - - - - - ranking = 1.5246927908043keywords = adenoma (Clic here for more details about this article) |
4/59. Secondary parathyroid hyperplasia in tuberous sclerosis: report of a case with large eosinophilic ganglion-like cells similar to those of subependymal giant cell astrocytoma, tubers, and atypical angiomyolipoma.We report a case of secondary parathyroid hyperplasia in a 49-year-old man with tuberous sclerosis. Two parathyroid glands had collections of large, eosinophilic ganglion-like endocrine cells that to our knowledge have not been previously described at this site. These cells are morphologically similar to those of subependymal giant cell astrocytoma, tubers, and atypical angiomyolipoma, all of which may arise in the setting of tuberous sclerosis. These large, eosinophilic ganglion-like cells found in different affected organs appear to be distinctive of tuberous sclerosis. We suggest these large eosinophilic cells arise from a common stem cell precursor that acquires variable phenotypes according to alterations in the cellular microenvironment.- - - - - - - - - - ranking = 0.33333333333333keywords = gland (Clic here for more details about this article) |
5/59. Mediastinal parathyroid cyst with tracheal constriction.A 63-year-old man visiting a physician for slight dyspnea, attributed to a lump on his neck, was found in ultrasonography and computed tomography to have a cyst extending from the left lobe of the thyroid gland to the superior mediastinum. radiography showed right deviation of the trachea. The cyst disappeared after fine-needle aspiration, but cyst fluid subsequently reaccumulated and he was admitted to our hospital. No abnormalities were detected in tests of thyroid and parathyroid function or blood chemical analysis. The cyst was surgically removed and diagnosed as a nonfunctioning parathyroid cyst, based on the high-intact parathyroid hormone in cyst fluid. The patient recovered fully and has shown no recurrence in the 11 months to data since surgery.- - - - - - - - - - ranking = 0.33333333333333keywords = gland (Clic here for more details about this article) |
6/59. Parathyroid agenesis: prenatal ultrasonographic features and pathological findings.We report a girl with parathyroid agenesis. The gross anomaly of the long bones was diagnosed prenatally by ultrasound. pregnancy was terminated at 24 weeks of gestation. There were no other apparent system anomalies except parathyroid gland agenesis and long bone abnormalities. This case is the first reported case of parathyroid agenesis with normal thyroid glands and other systems.- - - - - - - - - - ranking = 0.66666666666667keywords = gland (Clic here for more details about this article) |
7/59. Functional giant parathyroid cyst with high concentration of CA19-9 in cystic fluid.A 63-year-old man was admitted to our hospital for the evaluation of hypercalcemia and anterior neck mass. Laboratory findings revealed hypercalcemia, hypophosphatemia, and hypercalciuria, as well as elevated serum levels of parathyroid hormone (PTH) and alkaline phosphatase. Computerized tomography and magnetic resonance images showed that the mass contained a cystic area. Parathyroid scintigraphy using either 99mTc-sestamibi alone or 201Tl-chloride in conjunction with 99mTc-pertechnetate for thyroid image subtraction showed uptake of the radioactivity into the cyst wall, suggesting that the mass originated from the parathyroid. Fine needle aspiration biopsy revealed that the cyst fluid was serous and bloody with extremely high concentrations of both PTH and CA19-9. The patient was diagnosed as primary hyperparathyroidism caused by parathyroid cyst and cervical exploration was performed. The cyst was dissected away along with the right lobe of the thyroid gland. After tumor removal, serum calcium and PTH levels were normalized. Histological study showed that the tumor possessed malignant potential with capsular invasion as well as moderate cellular atypia with trabecular pattern in arrangement. Parathyroid cells in the wall of the cystic tumor were immunostained positively for CA19-9, suggesting that CA19-9 in the cyst fluid was produced from the cells.- - - - - - - - - - ranking = 0.33333333333333keywords = gland (Clic here for more details about this article) |
8/59. Coexistence of a parathyroid adenoma and parathyroid cyst causing primary hyperparathyroidism.The association of a functional parathyroid cyst with a parathyroid adenoma is an uncommon finding. In this report we describe the clinical history of a 60-yr-old man, presenting with the following findings: hypercalcemia (18.9 mg/dl), elevated serum parathormone levels (1320 pg/dl), hypercalciuria (228 mg/dl), and hyperphosphaturia (155 mg/dl). Neck ultrasound, magnetic resonance imaging (MRI) and 99Tc Sestamibi scintigraphy led to the identification of a left parathyroid adenoma, located at the lower pole of the left thyroid gland lobe, associated with a parathyroid cyst, located at the upper extremity of the same thyroid lobe. parathyroidectomy was performed and the histological examination confirmed the diagnosis of a parathyroid adenoma with aspects of cystic degeneration and an upper parathyroid cyst. Analysis of the crystal clear intracystic fluid showed elevated parathyroid hormone (PTH) levels (137.000 pg/ml). The patient is normocalcemic at 2 yr after surgery without signs of recurrent parathyroid enlargements. Aetiology, diagnosis and management of parathyroid cyst will be discussed.- - - - - - - - - - ranking = 5.6697581011485keywords = adenoma, gland (Clic here for more details about this article) |
9/59. Hyperfunctioning parathyroid cysts: a case report.Parathyroid cysts are infrequent lesions of which most are non-functional. They are often misdiagnosed as thyroid cysts. Pre-operative diagnosis and differentiation from thyroid cysts is generally difficult. We hereby report a case that was admitted to the emergency room and was diagnosed as hypercalcemic crisis. The mass found during the neck examination was thought to be a thyroid nodule. A right total and left subtotal thyroidectomy was performed. Palpable thyroid nodule was diagnosed as cystic parathyroid adenoma postoperatively. When a cystic lesion is found in the neck of a patient, a pararthyroid cyst should be considered.- - - - - - - - - - ranking = 0.76234639540216keywords = adenoma (Clic here for more details about this article) |
10/59. thallium-pertechnetate subtraction scanning in the preoperative localization of an ectopic undescended parathyroid gland.Although bilateral exploration is highly effective in the treatment of primary hyperparathyroidism, minimally invasive parathyroidectomy has evolved into the procedure of choice when a single parathyroid lesion can be localized preoperatively. In this article, we discuss the utilization of thallium-pertechnetate subtraction scanning (TPSS) after technetium Tc-99m sestamibi scintigraphy failed to localize an ectopic parathyroid adenoma. Subsequently, radioguided resection of an undescended parathyroid adenoma inferior to the left submandibular gland was performed with surgical cure after a single procedure. This case report illustrates the importance of TPSS as a second-line modality in preoperative adenoma localization, thereby using minimally invasive techniques to successfully treat this patient's primary hyperparathyroidism.- - - - - - - - - - ranking = 3.9537058528732keywords = adenoma, gland (Clic here for more details about this article) |
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