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Query: UMLS:C0001430 (adenoma)
 21,222 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Forty cases of primary hyperparathyroidism presenting over a 15 year period, have been reviewed. The disease was equally prevalent in both sexes with highest incidence in the sixth decade. Most patients presented with renal colic or calculi (73 percent) and skeletal disease was found in only 13 percent. A single parathyroid adenoma was found in 32 cases and hyperplasia was diagnosed in only two cases. Follow-up questionnaires were sent to 32 patients, and in 27 of these a full clinical and laboratory assessment was undertaken. Of 26 patients with renal colic preoperatively only six continued to experience colic one year after parathyroid surgery. Thirty percent of all patients were hypertensive preoperatively, and in only two patients did blood pressure normalise after surgery. Fourteen of 27 patients followed-up were found to be hypertensive. A highly significant fall was noted in serum calcium, chloride, alkaline phosphatase and urine calcium excretion postoperatively. Recurrence of the disease was low and less than 8 percent in this series. The low incidence (1 per 10 000 population per year) suggests that primary hyperparathyroidism is under diagnosed in the Christchurch community.
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PMID:Primary hyperparathyroidism in a New Zealand community: a review of 40 cases. 29 Aug 84

Renal calculi is an uncommon clinical presentation of parathyroid adenoma today. Only 17% of parathyroid adenoma has renal calculi in Levin's report. The association of parathyroid adenoma is often overlooked in the patients of renal calculi. We report a case whose clinical presentation is renal calculi with renal colic Parathyroid adenoma was not discovered until the second admission. The patient's clinical presentation improved after parathyroidectomy. We report this case to remind the clinical physician regarding the possibility of coexistence of parathyroid adenoma in patients of renal calculi. Excision of the parathyroid adenoma is the only treatment for these patients.
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PMID:[Parathyroid adenoma associated with bilateral renal calculi. A case report]. 280 80

During the last two decades, the clinical presentation of primary hyperparathyroidism (PHP) has changed due to the routine use of multiphasic biochemical screening tests. We assessed 84 patients with PHP treated in our service between 1977 and 1991. The yearly incidence increased from 1.6 to 7.6 patients/year with the introduction of multiphasic biochemical testing in our hospital in 1982; likewise the proportion of asymptomatic patients increased from 12.5 to 40.7%. The most frequent presenting symptoms were bone pain and renal colic. Nineteen percent of patients were over 70 years old and this age group had distinct clinical features. The plasma chlorine/phosphorus ratio was abnormal in 95% of cases; on the contrary only 7 of 18 patients had a urinary calcium excretion over 300 mg/day. Cervical ultrasound, performed in 45 patients had a positive predictive value of 78% to localize the lesion. Bone density was below fracture threshold in 50% of studied patients. The principal surgical finding was the presence of adenoma. Twenty one percent of patients had symptomatic hypocalcemia during the first week after surgery; however, only 2.5% of patients continued to have hypocalcemia one month after surgery. One patient had an inferior laryngeal nerve damage and two a cervical hematoma. It is concluded that the introduction of massive calcium measurements has allowed an early diagnosis of asymptomatic PHP, specially in elderly people.
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PMID:[Changes in the clinical presentation of primary hyperparathyroidism. Analysis of 84 cases]. 824 38

We retrospectively reviewed the presentation and management of children with primary hyperparathyroidism (PHPT) from 1973 to 1995 at a paediatric tertiary-care centre. There were 11 patients (6 females), aged 12.3-17.7 years at presentation, with sporadic PHPT confirmed by histopathology (single adenoma). Presentation consisted of renal colic, or non-specific gastrointestinal, musculoskeletal or neurological symptoms. Misdiagnosis was common until hypercalcaemia was identified, 0.5-24 months after onset of symptoms (mean 7.7 months). All patients had hypercalcaemia and low-normal serum phosphate. The parathyroid hormone (PTH) radioimmunoassay used before 1986 was elevated in 1/4 patients; the intact PTH assay used after 1986 was elevated in 7/7 patients. At presentation, six had end-organ damage: band keratopathy, renal lesions, and/or bone disease. Preoperative localization was accurate in 0/4 patients diagnosed before 1986, but 5/7 patients diagnosed after 1986: three by ultrasound or sestamibi scan alone, and two by ultrasound and technetium scan. Surgical outcome was not dependent upon the accuracy of pre-operative localization. PHPT is rare in children but usually associated with end-organ damage, presumably due to delayed diagnosis. It should be considered in the differential diagnosis of unexplained non-specific complaints. The intact PTH assay greatly assists pre-operative diagnosis. The usefulness of pre-operative localization requires further research.
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PMID:Primary hyperparathyroidism in a paediatric hospital. 901 86

To report the first known case of a completely intracorporeal robotic-assisted laparoscopic ileal ureter in the pediatric population, a 12-year-old boy with near-complete replacement of his right ureter with nephrogenic adenoma and resulting debilitating renal colic. Intracorporeal robotic-assisted laparoscopic ileal ureter was performed without complication. A detailed description of our surgical technique is included. The patient had improvement in hydronephrosis and complete resolution of renal colic symptoms with minimal incisional length compared to traditional laparotomy. Intracorporeal robotic-assisted laparoscopic ileal ureter provides the benefits of minimally invasive surgery when complete ureteral replacement is needed.
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PMID:First-ever Reported Obstructing Ureteral Nephrogenic Adenoma in a Child and Subsequent Robotic-assisted Laparoscopic Ileal Ureter. 2700 6

We report a case involving a female patient with primary hyperparathyroidism arising from a middle mediastinal parathyroid adenoma. Initial diagnosis was made based on a history of polyuria and recurrent renal colic. At the age of 77 she underwent videoscopic assisted mediastinoscopy (VAM) for resection of the adenoma which was localized using single-photon emission computed tomography (SPECT/CT). This case illustrates the importance for accurate pre-operative localization and intra-operative monitoring to ensure complete surgical removal in order to improve postoperative normocalcemia success rates.
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PMID:Excision of middle mediastinal parathyroid adenoma by videoscopic assisted mediastinoscopy (VAM). 2774 20

Paediatric hypercalcaemia is a rare condition which can be easily overlooked or misdiagnosed. We report two paediatric patients who presented to the Department of Paediatrics, Pardubice Hospital, Pardubice, Czech Republic, in 2009 and 2010, respectively. Each patient was diagnosed with hypercalcaemia due to a different cause. The first case involved a seven-month-old infant who presented with failure to thrive, vomiting and psychomotor retardation. Fluorescent in situ hybridisation revealed Williams-Beuren syndrome. The second patient was a 16-year-old girl with abdominal pain and renal colic due to hypercalcaemia-induced urolithiasis. High parathyroid hormone serum levels suggested primary hyperparathyroidism. An adenoma of the left upper parathyroid gland was diagnosed via technetium-99m-labelled methoxyisobutyl isonitrile single photon emission computed tomography and removed surgically. Hypercalcaemia should be considered in the differential diagnosis of various disease states, particularly among infants who fail to thrive or children with abdominal pain.
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PMID:Two Different Causes of Paediatric Hypercalcaemia. 3060 85