Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0001430 (adenoma)
 21,222 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 66-year-old woman presented with hypercalcemia and a past history of external radiation to the neck. Hyperparathyroidism in this patient was caused by a parathyroid adenoma. The literature associating hyerparathyroidism with prior radiation of the head and neck was reviewed and analyzed. Current evidence supports a relationship between external radiation of the head or neck and the development of hyperparathyroidism as a late complication. Analysis of data available suggests that radiation-association hyperparathyroidsim develops after an average latent period of 38 years. Parathyroid adenoma occurred more often than did hyperplasia. Parathyroid carcinoma has not been reported in irradiated patients with hyperparathyroidsim. Neither age at radiation exposure, age at diagnosis of hyperparathyroidsim, nor interval between exposure and diagnosis was associated with a specific histologic diagnosis (adenoma or hyperplasis).
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PMID:Hyperparathyroidism after radiation of the head and neck: a case report and review of the literature. 53

A description of a very rare malignant tumor, cancer of the parathyroid gland which developed in adenoma of this gland is presented. The histological study of the tumor revealed an adenoma of the trabecular structure consisting mostly of dark oxyphilic cells. In its turn, an area of trabecular cancer was found in the adenoma. Complexes of cancer cells infiltrated the adenomal tissue in some sites, but never grew through its capsule. The tumor was hormonally active like most cancers of the parathyroid gland. A particular feature of this case is the development of cancer in adenoma of the parathyroid gland which did not grow beyond the adenoma and produced no metastases.
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PMID:[Cancer developing in the adenoma of the parathyroid gland]. 90 20

Recurrent hyperparathyroidism occurred in 11 of 295 patients from 10 months to 34 years after an initially successful operation. Seven patients with recurrent hyperparathyroidism had either multiple endocrine adenomatosis type I (MEA) or familial hyperparathyroidism (FHP), one patient had parathyroid cancer, and two patients had renal failure at the time of recurrence. Four of these patients ahd their initial operations elsewhere. Recurrence developed in 33% of patients with MEA or FHP but in only 0.4% of 242 patients without MEA or FHP. The presence of MEA or FHP was known before parathyroid exploration in 18 (86%) of the 21 patients. In patients with MEA or FHP, subtotal parathyroidectomy should be performed if there is more than one gland involved. Other patients should be treated by selective removal of an adenoma because recurrence is rare. Subtotal parathyroidectomy should be reserved for patients with diffuse hyperplasia.
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PMID:Recurrent hyperparathyroidism. 101 86

A series of 46 patients had a tissue diagnosis of primary hyperparthyrodism. Forty (88%) had a single adenoma, one had multiple adenomas; four exhibited parathyroid hyperplasia and one had carcinoma of the parathyroid. The incidence establishing the diagnosis has increased in recent years because of routine multichemistry screening for calcium. The most reliable "diagnostic" laboratory finding was an elevated serum calcium: 96 per cent of our patients had serum calcium above the upper limit of normal. Forty-one patients had lesions removed; parathyroid carcinoma (1), hyperplasia (3), and adenomas (37). Only two patients have presistent disease postoperatively: one with hyperplasia who apparently had an inadequate resection of her involved glands and one who had biopsy of an adenoma without further surgical management.
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PMID:Primary hyperparathyroidism in a referral hospital. 111 55

Primary or relapsing hyperparathyroidism should not be considered a result only of benign conditions like adenoma or hyperplasia (primary or secondary). Parathyroid carcinoma is often the real cause but, because of its rarity, sometimes it is either overlooked or misdiagnosed. Even histologic classification can be erroneous. Distant metastases or ectopic location of the tumors are another potential cause of misdiagnosis, especially when management is decided without the help of diagnostic imaging modalities, particularly those related to the functional aspect of the tumors or their metastases, such as the Tl-201/Tc-99m subtraction scan and the Tl-201 whole body scan.
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PMID:Parathyroid carcinoma. Report of three cases. 131 97

Among 1819 patients with renal stone disease 44 cases with primary hyperparathyroidism (p.h.p.) were diagnosed. In all cases the diagnosis of php was confirmed by histomorphological examination. In 34 patients with php solitary adenoma was found, in 5 patients an adenoma with concomitant hyperplasia of the parathyroid glands, in 2 patients hyperplasia and in 3 patients carcinoma of the parathyroid glands. Hypercalcemia was found in 86% of patients, while elevated plasma levels of PTH in 90% of patients with php. Not in all patients PTH secretion was entirely autonomous. No significant correlation was found between plasma levels of PTH and kind of pathology of the parathyroid glands as well as clinical feature of php respectively.
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PMID:[Hypercalciuria and primary hyperparathyroidism in patients with kidney calculi. II. Primary hyperparathyroidism]. 164 64

Hyperplasia of the parathyroid glands is a central feature of familial multiple endocrine neoplasia type 1. We used cultured bovine parathyroid cells to test for mitogenic activity in plasma from patients with this disorder. Normal plasma stimulated [3H]thymidine incorporation, on the average, to the same extent as it was stimulated in a plasma-free control culture. This contrasted with the results of the tests with plasma from patients with familial multiple endocrine neoplasia type 1, in which parathyroid mitogenic activity increased 2400 percent over the control value (P less than 0.001). Plasma from these patients also stimulated the proliferation of bovine parathyroid cells in culture, whereas plasma from normal subjects inhibited it. Parathyroid mitogenic activity in plasma from the patients with familial multiple endocrine neoplasia type 1 was greater than that in plasma from patients with various other disorders, including sporadic primary hyperparathyroidism (with adenoma, hyperplasia, or cancer of the parathyroid), sporadic primary hypergastrinemia, sporadic pituitary tumor, familial hypocalciuric hypercalcemia, and multiple endocrine neoplasia type 2 (P less than 0.05). Parathyroid mitogenic activity in the plasma of patients with familial multiple endocrine neoplasia type 1 persisted for up to four years after total parathyroidectomy. The plasma also had far more mitogenic activity in cultures of parathyroid cells than did optimal concentrations of known growth factors or of any parathyroid secretagogue. This mitogenic activity had an apparent molecular weight of 50,000 to 55,000. We conclude that primary hyperparathyroidism in familial multiple endocrine neoplasia type 1 may have a humoral cause.
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PMID:Parathyroid mitogenic activity in plasma from patients with familial multiple endocrine neoplasia type 1. 287 88

Since the adrenal or parathyroid cancer is a clinically rare entity. We often have difficulty in its diagnosis and treatment. The adrenocortical cancer is usually classified into two categories--endocrinologically functioning or non-functioning. The incidence is not different between them. It is often found in an advanced stage as it does not show clinical manifestation before it has grown up to a large tumor. Only an effective agent for the adrenal cancer is op'-DDD so far. Recently, cisplatin, VP-16 (etoposide) and others are administered as trial use. Most of malignant pheochromocytomas are endocrinologically active and they often cause hypertension leading to death. Therefore it is important to control hypertension in malignant pheochromocytoma. Chemotherapy and irradiation are not effective for it. Recently, 131I-MIBG (metaiodobenzylguanidine) is found to be useful not only for diagnosis but also treatment of malignant pheochromocytoma. 131I-MIBG is accumulated specifically in the chromaffin cells and with helpful to find out metastatic foci. It is also used in a large amount as a specific irradiation therapy for this malignancy. Parathyroid cancer is found in approximately 3 percent of primary hyperparathyroidism. Clinically it usually reveal serum calcium level higher than 14 mg/dl, bone lesions and renal dysfunction in addition to palpable cervical tumors adhering with skin. Sometimes it is difficult to differentiate malignancy from adenoma in histology. Most cases develop local recurrences and distant metastases in due course and dies of hypercalcemia. It is very important to control hypercalcemia in inoperable cases. As both chemotherapy and radiation therapy render no effect on this malignancy. Surgery is a sole strategy for it.
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PMID:[Current therapy of endocrine organ tumors (adrenal and parathyroid glands)]. 334 84

Parathyroid carcinoma is a rare tumor and its clinical course is variable. Differentiation of patients with parathyroid carcinoma from those with parathyroid adenoma is often difficult both preoperatively and at operation. For good results, the surgeon must recognize this disorder and perform an en bloc resection at the initial surgery. A neck dissection is necessary only when there is evidence of regional node metastases. After surgery, periodic follow-up of the serum calcium and iPTH levels is essential. When hypercalcemia recurs or the serum iPTH increases, localization studies with the use of thallium-201 scanning help detect local recurrence and regional lymph node metastases, but unfortunately, this method often fails to localize pulmonary metastases. Chest radiographs and CT scanning are useful for delineating pulmonary metastases. A wide excision of locally recurrent tumor, an en bloc radical neck dissection and mediastinum dissection for lymphatic metastases, and an aggressive surgical resection of lung metastases are recommended. Although these operations are rarely curative, they usually offer definite palliation of the marked hypercalcemia, often for a considerable period. Drugs to lower the serum calcium level and systemic chemotherapy are currently of only limited benefit, and radiation therapy is generally ineffective.
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PMID:How to recognize and treat parathyroid carcinoma. 355 Nov 49

Parathyroid adenomas are subdivided into chief cell and oxyphil cell variants. However, the parathyroid carcinomas described thus far have been only of the chief cell type. Two cases of oxyphil cell carcinoma of the parathyroid gland are reported, with light and electron microscopic study. The patients presented apparent clinical hyperparathyroidism with x-ray finding of generalized fibrous osteitis and palpable parathyroid tumors. Initially, a pathologic diagnosis of parathyroid adenoma was made in both of them. However, in due course, pulmonary metastases developed in one patient and a local recurrence occurred in the other, 5 and 8 years after the primary operation, respectively. Review of the microscopic slides showed that both primary tumors met the criteria of parathyroid carcinoma. A matter of interest in both cases is that the neoplasms were composed principally of oxyphil cells. Electron microscopic study confirmed the existence of typical oxyphil cells packed with numerous mitochondria.
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PMID:Parathyroid carcinoma of the oxyphil cell type. A report of two cases, light and electron microscopic study. 397 40


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