1/661. The elevated serum alkaline phosphatase--the chase that led to two endocrinopathies and one possible unifying diagnosis.A 39-year-old Chinese man with hypertension being evaluated for elevated serum alkaline phosphatase (SAP) levels was found to have an incidental right adrenal mass. The radiological features were characteristic of a large adrenal myelolipoma. This mass was resected and the diagnosis confirmed pathologically. His blood pressure normalised after removal of the myelolipoma, suggesting that the frequently observed association between myelolipomas and hypertension may not be entirely coincidental. Persistent elevation of the SAP levels and the discovery of hypercalcaemia after surgery led to further investigations which confirmed primary hyperparathyroidism due to a parathyroid adenoma. The patient's serum biochemistry normalised after removal of the adenoma. The association of adrenal myelolipoma with primary hyperparathyroidism has been reported in the literature only once previously. Although unconfirmed by genetic studies this association may possibly represent an unusual variation of the multiple endocrine neoplasia type 1 syndrome.- - - - - - - - - - ranking = 1keywords = adenoma (Clic here for more details about this article) |
2/661. Sudden recurrent laryngeal nerve paralysis due to apoplexy of parathyroid adenoma.Neoplastic lesions of the parathyroid are rare, and most of these are adenomas. Even rarer is a secondary involvement of the recurrent laryngeal nerve. A case is presented of sudden onset hoarseness in a 64-year-old man caused by acute vocal cord paralysis due to bleeding within an adenoma of the lower right parathyroid gland. Acute onset of vocal cord paralysis is rarely associated with benign processes; the current case is only the second report associated with parathyroid adenoma.- - - - - - - - - - ranking = 3.5090058202113keywords = adenoma, gland (Clic here for more details about this article) |
3/661. Median sternotomy for parathyroid adenoma.Most mediastinal parathyroid tumours lie within the thymus gland and may be retrieved when cervical thymectomy is carried out in the course of neck exploration for primary hyperparathyroidism (HPT). We report 4 patients, each of whom required sternotomy for removal of a true mediastinal parathyroid adenoma. Subtraction isotope scintigraphy suggested the presence of a mediastinal tumour prior to cervical exploration in 2 individuals and prior to re-exploration in a third. When localisation before initial exploration for HPT suggests a parathyroid tumour within the chest, consideration should be given to proceeding to sternotomy, at first operation if a comprehensive neck exploration, including cervical thymectomy, fails to uncover the adenoma. Uniquely, one of our patients underwent sternotomy for HPT when 23 weeks pregnant.- - - - - - - - - - ranking = 3.0090058202113keywords = adenoma, gland (Clic here for more details about this article) |
4/661. A large intrathoracic parathyroid adenoma.A case is described in which an unusually large parathyroid adenoma was visible on the plain chest radiograph taken during the investigation of hypercalcaemia. This was diagnosed preoperatively and a scheme is suggested whereby such a disgnosis can now readily be made. The differential diagnosis is discussed ant the literature is reviewed.- - - - - - - - - - ranking = 2.5keywords = adenoma (Clic here for more details about this article) |
5/661. meningioma associated with parathyroid adenoma.A woman hospitalized because of attempted suicide with diazepam tablets was found to have hypercalcemia and other signs of hyperparathyroidism. Electroencephalogram indicated a brain lesion which was confirmed by a brain scan and angiogram. The hypercalcemia persisted after removal of the meningioma and serum levels of calcium returned to normal only after a parathyroid adenoma was removed during an additional intervention. This association of meningioma with hyperparathyroidism is unique in the literature. The difficulties of diagnosis resulting from the neuropsychiatric symptoms common to the two disorders are discussed.- - - - - - - - - - ranking = 2.5keywords = adenoma (Clic here for more details about this article) |
6/661. Bilateral hemothorax revealing mediastinal parathyroid adenoma.We report the case of a 63-year-old woman admitted to hospital because of bilateral hemothorax associated with acute respiratory failure and laterotracheal neoformation. A right thoracoscopy biopsy revealed a paratracheal parathyroid adenoma which was responsible for bilateral hemothorax and primary hyperparathyroidism. A curative resection was successfully performed by cervicotomy.- - - - - - - - - - ranking = 2.5keywords = adenoma (Clic here for more details about this article) |
7/661. Ganglioneuromatous polyposis of the colon associated with adenocarcinoma and primary hyperparathyroidism.A rare case of ganglioneuromatous polyposis of the colon found in association with mucinous adenocarcinoma and primary hyperparathyroidism caused by a parathyroid adenoma in a 77-year-old woman is described. We discuss the clinical implications of this finding and review the literature.- - - - - - - - - - ranking = 0.5keywords = adenoma (Clic here for more details about this article) |
8/661. A peculiar factor viii-related antigen staining of an oxyphilic cell nodule within an intrathyroidal parathyroid adenoma.A case of intrathyroidal parathyroid adenoma, which was found in the lower portion of the right thyroid lobe, is presented. The nodule in this lesion was composed of oxyphilic cells. In order to verify a possible vascular invasion, immunohistochemical study with factor viii-related antigen/von willebrand factor, which is known to be synthesized by the endothelial cells and stored in weibel-palade bodies, and ulex europaeus lectin 1 were applied. It was interesting to find positivity for factor viii-related antigen and ulex europaeus lectin I strictly confined in the nodule of oxyphil cells, which are known to have large numbers of mitochondria. This led to investigating similar immunoreactions in different lesions of oxyphilic cells with several other markers. The possible cross-reaction between weibel-palade bodies and mitochondria deserves further detailed research.- - - - - - - - - - ranking = 2.5keywords = adenoma (Clic here for more details about this article) |
9/661. technetium-99m pertechnetate uptake in ectopic parathyroid adenoma.A 37-year-old male with a persistent increased parathyroid hormone level, after subtotal thyroidectomy and parathyroidectomy, was referred for scintigraphic localization of a possible ectopic parathyroid adenoma. Tc-99m pertechnetate and Tc-99m MIBI scintigraphy were performed on separate days. There was marked uptake of both tracers in the mediastinum, which at surgery was confirmed to be an extrathyroidal parathyroid adenoma. Hypervascularity was suggested as a possible explanation for rare cases of pertechnetate avid parathyroid adenomas. And Tc-99m MIBI scintigraphy proved to be a successful imaging procedure for ectopic parathyroid tissue.- - - - - - - - - - ranking = 3.5keywords = adenoma (Clic here for more details about this article) |
10/661. Cytogenetic and CGH studies of four neuroendocrine tumors and tumor-derived cell lines of a patient with multiple endocrine neoplasia type 1.A malignant insulinoma (LOHG-I), a carcinoid of the lung (LOHG-L), a parathyroid adenoma (LOHG-NSA), and a fibroma (LOHG-F) were obtained from a patient with multiple endocrine neoplasia type 1 (MEN1). Long-term cultures were established. Essential neurobiological properties of the cell lines were proven immunocytochemically and by electron microscopy. Molecular analysis of the germline dna showed a 4 bp deletion in exon 3 of the MEN1 gene. Cytogenetic and CGH analyses of the tumors/tumor cell lines revealed diploidy and balanced and unbalanced structural aberrations different for each tumor. chromosomes 6q21, 11q and 17q were most frequently involved in clonal structural aberrations.- - - - - - - - - - ranking = 0.5keywords = adenoma (Clic here for more details about this article) |
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