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)

The different subgroups of hypercalciuria cannot be separated clearly by the Pak calcium-load test. To improve the diagnosis and therapy we examined all relevant parameters of calcium metabolism in 32 patients with calcium urolithiasis and hypercalciuria (> 6.25 mmol/day). We also conducted bone mineral density measurements as well as the Pak calcium-load test. In most cases the pathophysiological constellations which Pak takes as the basis for his classification of hypercalciuria could not be shown. To date, diagnostics only insufficiently explains the genesis of hypercalciuria (except pHPT). As a consequence, a therapeutic problem arises: a low-calcium diet should not be generally recommended, since some patients may develop osteopenia. From our investigation the following diagnostic and therapeutic conclusions can be drawn: (1) Hypercalciuria in primary hyperparathyroidism should be treated by surgical removal of the adenoma. (2) The parathormone-independent osteogenic form should be treated with thiazides. (3) Hypercalciuria with increased 1.25-dihydroxyvitamin D should be treated by low-calcium diet.
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PMID:[Studies of calcium metabolism in patients with hypercalciuria]. 899 31

A 55-year-old male with multiple endocrine neoplasia syndrome accompanied by hyperparathyroidism and hypergastrinemia was admitted because of local recurrence of thymic carcinoid tumor and a parathyroid adenoma. The recurrent thymic carcinoid tumor replaced anterior mediastinum, invaded brachiocephalic vein and superior vena cava, a disseminated nodule was found at pericardium. After induction chemotherapy using carboplatin and etoposide the operation was performed. The parathyroid tumor and recurrent thymic carcinoid tumor were removed completely together with brachiocephalic vein, superior vena cava, pericardium and anterior chest wall. Superior vena cava was replaced with synthetic graft and chest wall was reconstructed. The patient is alive and well 22 months after surgery without recurrence. Immunohistochemistry of removed specimens revealed parathormone and gastrin secreted from the parathyroid adenoma but not from the carcinoid tumor. Careful survey of systemic endocrine organs is necessary in case of thymic carcinoid tumor. Aggressive surgery in locally recurrent thymic carcinoid without distant metastasis must be considered.
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PMID:[Recurrent thymic carcinoid tumor with multiple endocrine neoplasia syndrome--a case report]. 907 Nov 47

Two cases of fine needle aspiration cytology of parathyroid adenoma were not misinterpreted as microfollicular nodules of the thyroid. Discrimination of those two lesion is a diagnostic pitfall in cytological material. Authors pointed out criteria for differential diagnosis. Radioimmunoanalysis of parathormone in aspirate served as a simple, safe and reliable method in these cases.
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PMID:[Differentiating parathyroid adenoma from microfollicular thyroid nodule in fine-needle aspiration cytology]. 911 31

Acute onset of primary hyperparathyroidism is uncommon; neuropsychiatric signs are prominent clinical features in acute hypercalcemia and they can subside after normalization of serum calcium. Radiation therapy is a well-known risk factor for non medullary thyroid cancer, but it induces also parathyroid tumors. Data from the literature show that patients previously treated with neck radiation have an increased risk of primary hyperparathyroidism. Furthermore concomitant thyroid cancer is more frequent in radiation-induced hyperparathyroidism than in sporadic primary hyperparathyroidism. The case of a 63-year-old female patient who at the age of 14 had been irradiated to the neck for goiter and at the age of 50 had been repeatedly hospitalized for psychosis is presented. She was admitted to the hospital for suspected recurrence of psychosis, but clinical findings and urgent biochemical data showed on the contrary that she had a severe hypercalcemic crisis. Serum parathormone concentrations, neck echography and 99mTc-Sestamibi scintigraphy suggested hyperfunction of the right lower parathyroid gland; therefore the patient was operated on. Pathological examination disclosed a parathyroid adenoma but also two foci of follicular cancer in the right thyroid lobe with a metastasis to a lymph node were observed. Neuropsychiatric signs disappeared after normalization of calcemia and 6 months after operation the patient is free from psychiatric symptoms, despite she had stopped neurolectic drugs. It is underlined that patients who had received neck irradiation must be carefully observed because they are at increased risk of primary hyperparathyroidism and concurrent thyroid cancer.
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PMID:[Acute hyperparathyroidism associated with follicular carcinoma in the thyroid: possible role of juvenile cervical irradiation. Description of a case]. 922 12

Two cases of vitamin D deficient osteomalacia with secondary hyperparathyroidism are presented. In both cases treatment with vitamin D replacement therapy resulted in elevated calcium levels and a failure of parathormone levels to normalise, indicating autonomous parathyroid activity. Subsequent surgery in one case resulted in removal of a parathyroid adenoma. The importance of osteomalacia and its complications are discussed.
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PMID:Treatment of vitamin D deficient osteomalacia may unmask autonomous hyperparathyroidism. 949 53

An unusual presentation of a granular cell tumor is reported with a review of the natural history and pathologic characteristics of this tumor. Our patient was asymptomatic and presented with a mass in the inferior right neck on routine physical examination. Preoperative radiologic evaluation suggested a parathyroid adenoma but the normal parathormone level was inconsistent with this diagnosis. At surgery, a firm mass was identified inferior to the right lobe of the thyroid gland and was found to represent a granular cell tumor densely adherent to the trachea. This case demonstrates a unique presentation for this relatively rare neoplasm which was treated with complete surgical resection.
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PMID:Unique presentation of a granular cell tumor as a paratracheal mass. 976 4

Cope showed in 1957 that pancreatitis may be the presenting symptom in hyperparathyroidism. Since then, the literature has reported a coincidence of primary hyperparathyroidism and pancreatitis between 1% and 19%, but the true relationship has not been fully established. When severe pancreatitis follows parathyroidectomy, a condition familiar to parathyroid surgeons, reports are mostly anecdotal and by many authors considered to be coincidental. We present the case history of a 58-year-old man with a longstanding history of untreated primary hyperparathyroidism who developed severe pancreatitis immediately after removal of a 400-mg parathyroid adenoma. He was the first in a series of 108 operated patients to develop this complication. His preoperative levels of parathormone and serum calcium were the highest in our material. We believe that pancreatitis after parathyroidectomy is a real but rare complication that might be predicted by preoperative high values of serum calcium and parathormone.
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PMID:Severe pancreatitis after parathyroidectomy. 1083 Dec 71

Primary hyperparathyroidism is a rather frequent pathology characterised by hypersecretion of parathormone (PTH) which is caused by adenomas in 85% of all cases. At clinical onset, the most common symptoms are hypercalcemia-related (pain due to kidney stones, polyuria, gastrointestinal and neurological disorders) while rarer symptoms are due to brown tumors, expansive lesions often found in fibro-cystic osteitis. A case in which the patient showed recurrent mandibular brown tumors as initial clinical symptoms of primary hyperparathyroidism is described. This patient was examined for hypercalcemia, and a tumor mass at the left inferior mandibular branch was found. The patient had undergone surgical removal of a tumor in the left mandibular some years before, which was diagnosed as osteoclastoma. Primary hyperparathyroidism was diagnosed during recovery, and surgical removal of the parathyroid adenoma and mandibular tumor was performed. A histological diagnosis of large cell brown tumor was made. A microscopic observation of brown tumors which are made up of large multinuclear osteoclastic cells can often be confused with other large cell tumors during diagnosis. It is therefore necessary to exclude the presence of hyperparathyroidism with ionised calcium and, in cases of high values, intact PTH (iPTH), before performing a histological diagnosis of a large cell bone tumor. Throughout the course of primary hyperparathyroidism, brown tumors might appear in the absence of other specific symptoms and localize at the level of a single bone segment.
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PMID:[Recurrent brown tumors as initial manifestation of primary hyperparathyroidism. An unusual presentation]. 1108 46

Two cases of women with primary hyperparathyroidism caused by parathyroid cancer were presented. The authors noticed the following characteristic features of primary hyperparathyroidism in the course of the cancer: rich clinical symptomatology usually in form of considerable bone destruction, renal stones and nephrocalcinosis, biochemically very high level of calcium, above 14-16 mg%, threatening with hypercalcemic crisis and considerably higher parathormone serum concentration even up to twenty times above the norm. Parathyroid cancer, more often than adenoma, is a stiff and large neck tumour accessible for palpation. There are no specific biochemical and imagining examination techniques to recognise beyond any doubt the cancer character of primary hyperparathyroidism before operation. The histopathological diagnosis of this cancer is difficult and is not usually done intraoperatively. The recurrences of the malignancy are typical and they require reoperations after stating places of relapse or metastases.
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PMID:[Characteristic features of primary hyperparathyroidism caused by parathyroid cancer--based on 2 cases]. 1110 73

EGFR (epidermal growth factor receptor), p53, and proliferative markers provide some clues as to the formation of several tumours. In this study the mechanism of the genesis of parathyroid adenomas was investigated using immunohistochemistry. Sections of parathyroid adenomas from 12 cases were stained using PCNA (proliferating cell nuclear antigen), EGFR, and p53 immunohistochemistry. Correlations between PCNA LI (labelling index), EGFR expression, p53 expression, age, serum parathormone, Ca and P levels, and tumour diameter were investigated. PCNA LI was 45.8+/-33.1 (mean+/-standard deviation) and all the cases were somewhat positive. Five cases (41.67 %) were EGFR positive. Maximum 10 % of the cells were positive in these cases. All the cases were p53 negative. There was a correlation between PCNA LI and serum parathormone level (r=0.607, p=0.036). According to these results, parathormone synthesis is high when the proliferative activity of parathyroid adenoma is high. Four of the five EGFR-positive patients were below 35 years of age. These data may indicate that formation of parathyroid adenoma in young patients is related to a mechanism involving EGFR. Absence of p53 expression suggests that p53 mutation is not a common component of parathyroid adenomas.
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PMID:EGFR and p53 expression and proliferative activity in parathyroid adenomas; an immunohistochemical study. 1184 29


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