Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0221002 (primary hyperparathyroidism)
 4,921 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The first case of primary hyperparathyroidism associated with renal cell carcinoma, nasopharynx carcinoma and thyroid carcinoma is reported. Selective venous sampling with radioimmunoassays for parathyroid hormone was helpful in the differentiation of primary hyperparathyroidism from hypercalcemia associated with malignancy.
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PMID:Primary hyperparathyroidism with triple cancers consisting of renal cell carcinoma, nasopharynx carcinoma and thyroid carcinoma. 83 5

A case of an elderly female patient, presented with a rare association of primary hyperparathyroidism and renal cell carcinoma, is reported. As a common finding in the elderly, the patient had mild hypercalcaemia for many years but she developed several complications from untreated hyperparathyroidism. The mechanisms of malignant hypercalcaemia are discussed and the importance of properly investigating and managing symptomatic primary hyperparathyroidism in the elderly is emphasised.
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PMID:Primary hyperparathyroidism and renal cell carcinoma in an elderly patient: a rare association. 145 2

Hypercalcemia is one of the most serious metabolic disorders associated with cancer. The incidence and clinical circumstances associated with hypercalcemia vary in different types of cancer. Hypercalcemia is the most frequent metabolic complication of breast cancer and is usually related to widespread osteolytic metastases; however, local and systemic humoral factors mediating bone resorption have been described. In some patients with breast cancer, hypercalcemia results from treatment with estrogens, antiestrogens, androgens, or progestins. Coexisting primary hyperparathyroidism rarely confounds the diagnosis. In patients with lung cancer, the incidence of hypercalcemia varies with histology and is often unrelated to bone metastases. Hypercalcemia may occur either late or early in the disease but is seldom a presenting symptom. In patients with cancers of the head and neck region, hypercalcemia is most often associated with advanced recurrent and terminal disease, presumably humorally mediated. In renal cell carcinoma, hypercalcemia is also an adverse prognostic indicator, commonly mediated by humoral factors. On the other hand, almost all patients with multiple myeloma have extensive osteolytic bone destruction and hypercalcemia is frequently a presenting symptom. Hypercalcemia is uncommon in most lymphomas; however, it is usually a prominent feature of adult T-cell lymphomas and also occurs in some large cell, diffuse B-cell lymphomas. Awareness of the setting in which hypercalcemia of malignancy occurs will lead to its prompt diagnosis and institution of appropriate therapy.
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PMID:Overview of cancer-related hypercalcemia: epidemiology and etiology. 218 51

Medullary sponge kidney (MSK), parathyroid adenoma, renal cell carcinoma, and renal-leak hypercalciuria coincided in 1 female patient. Renal-leak hypercalciuria was not corrected by removal of a parathyroid adenoma. Since the patient had renal tubular acidosis (RTA), alkali treatment was conducted and resulted in the correction of hypercalciuria. Renal cell carcinoma eventually developed and MSK was confirmed histologically. This case suggests that MSK and primary hyperparathyroidism occurred independently.
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PMID:Medullary sponge kidney and hyperparathyroidism. 334 Nov 5

Serum concentrations of immunoreactive parathyroid hormone (iPTH) measured with a mid-region specific radioimmunoassay and total calcium were correlated in 300 healthy subjects and 158 patients with surgically verified primary hyperparathyroidism (HPT). All the healthy individuals could be separated from the patients by a monoexponential declining curve in which iPTH at concentrations of 0.60 micrograms/l and 0.33 micrograms/l corresponded to calcium concentrations of 2.20 mmol/l and 2.60 mmol/l, respectively. In 22 patients more than one sample was analysed and serum iPTH and calcium were inversely correlated. In contrast, three patients with parathyroid carcinoma showed no reciprocal fluctuations between serum iPTH and calcium. Of 75 patients with hypercalcaemia due to malignant diseases (metastatic mammary carcinoma, bronchial carcinoma, renal carcinoma, myelomatosis), 62 had a normal iPTH/calcium relationship. Two patients with myelomatosis had a temporary elevation of serum iPTH and calcium due to renal impairment. One patient with bronchial carcinoma probably had ectopic production of iPTH. The remaining 10 patients (six mammary carcinomas and four bronchial carcinomas) were found in the pathological iPTH/calcium range. In conclusion, we have demonstrated that an inverse relationship exists between serum iPTH and calcium in patients with non-malignant, primary HPT. Evaluation of iPTH and calcium in the same serum sample gave a correct diagnosis in more than 90% of patients with primary HPT.
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PMID:Improved diagnosis of primary hyperparathyroidism by defining the inverse relationship between serum immunoreactive parathyroid hormone and calcium. 374 90

During the past 16 years, in which 1,600 patients were surgically treated for primary hyperparathyroidism, 10 of these patients also were operated on for hypernephroma; in another patient a hypernephroma was detected 7 2/3 years after treatment for hyperparathyroidism. Four additional patients have elevated serum calcium and immunoreactive parathyroid hormone values after nephrectomy for hypernephroma, and a provisional diagnosis of primary hyperparathyroidism has been made in these patients. Thus, the occurrence in the same patient of two disorders that may have similar biochemical abnormalities produced by similar pathophysiologic mechanisms provides a unique diagnostic challenge to the physician. The correct diagnosis of these occasionally associated disorders is facilitated by a high degree of alertness and the performance of adequate renal radiographic procedures. These should include excretory urography in patients with persistent hypercalcemia unless the procedure is contraindicated.
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PMID:Primary hyperparathyroidism associated with hypernephroma: a diagnostic challenge. 713 30

Parathyroid adenomas are common lesions and are considered to be the cause of most of the primary hyperparathyroidism cases. We report the case of a 73 year-old man who presented with a primary hyperparathyroidism. Clinical and histological explorations revealed the presence of an isolated parathyroid tumor containing exclusively clear cells and devoid of malignancy. This is the second reported case of clear cell parathyroid adenoma. Thus, in spite of its low occurrence, this diagnosis must be considered after rejection of the most frequent parathyroid clear cell hyperplasia and parathyroid carcinoma, or depending of the location, clear cell thyroid tumor and clear cell renal carcinoma metastasis.
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PMID:[Clear cell adenoma of the parathyroid gland: a rare and misleading lesion]. 1054 68

A rare case of von Hippel-Lindau (VHL) disease with bilateral pheochromocytomas, right renal cell carcinoma, right pelvic carcinoma, spinal hemangioblastoma and primary hyperparathyroidism is described. A 78-year-old woman had a history of hypertension from her forties. She suffered from headache and body weight loss. Abdominal CT revealed bilateral adrenal tumors and right external renal tumors enhanced in early stage. MIBG scintigraphy exhibited a high accumulation of tracer in both adrenal glands. On the basis of the radiographic findings and endocrinological results, the patient was diagnosed as having bilateral pheochromocytomas and right renal cell carcinoma. A bilateral adrenectomy was performed, followed by surgery for resection of the renal cell carcinoma. The other resected right kidney showed a clear cell subtype that was determined to be renal cell carcinoma, and proved that the pelvic tumor was transient cell carcinoma. Spinal MRI showed spinal hemangioblastoma. von Hippel-Lindau (VHL) gene mutation for the patient was found. We diagnosed the patient as VHL because of the existence of spinal hemangioma and a VHL disease gene. Parathyroid echo revealed a hypoechoic space on the back of the left lobe, and serum calcium and intact PTH to be elevated. The patient was diagnosed as primary hyperparathyroidism. We report the first case of a patient with VHL disease complicated with bilateral pheochromocytomas, right renal cell carcinoma, right renal pelvic carcinoma and primary hyperparathyroidism. The life expectancy of affected individuals has been less than 50 years. Since the prognosis may be improved by an early diagnosis, affected individuals with VHL complexes should undergo cranial, spinal MRI and abdomen CT. The families may benefit from presymptomatic detection of affected gene carriers and the exclusion of at-risk family members by negative test results.
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PMID:A case of von Hippel-Lindau disease with bilateral pheochromocytoma, renal cell carcinoma, pelvic tumor, spinal hemangioblastoma and primary hyperparathyroidism. 1208 Dec 37

Cases of patients developing lymphoma and cutaneous neoplasms after long-term methotrexate therapy are well documented in the literature; however, there are no reported cases of other neoplasms resulting from methotrexate therapy. A 52-year-old woman who had been on methotrexate for 9 years for psoriatic arthritis was found to have abnormal liver function tests on screening. Investigation with ultrasound, CT scanning and MRCP showed a hilar cholangiocarcinoma and a synchronous right renal tumour. A left hemi-hepatectomy extended to segments 5 and 8 with the formation of a hepaticojejunostomy was performed for a poorly differentiated infiltrative hilar cholangiocarcinoma. This was combined with a right radical nephrectomy for a T1 renal cell adenocarcinoma. Postoperative vomiting was subsequently found to be due to hypercalcaemia and primary hyperparathyroidism. A parathyroid adenoma was later excised. It seems likely that treatment with methotrexate was causal in the development of these three non-cutaneous neoplasms-two malignant and one benign.
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PMID:Cholangiocarcinoma, renal cell carcinoma and parathyroid adenoma found synchronously in a patient on long-term methotrexate. 1833 65

With over 2 000 articles published on thyroid cancer between January 1, 2006 and September 10, 2007 it is difficult to offer an updated and complete review on this malignancy. Thus, I elected to summarize papers published in 2007 on topics frequently overlooked in other reviews or books, and papers that are likely to be followed by interesting developments. Papers include: 1) the accuracy and currency of websites on thyroid cancer; 2) the detection of the V600E BRAF mutation in very small papillary thyroid cancers that are detected histologically; 3) the relationship between thyroid cancer and Hashimoto's thyroiditis or hepatitis C virus, an association that appears to be nonrandom; 4) the not negligible frequency of coexistence of thyroid cancer with primary hyperparathyroidism; 5) the value of ultrasound elastography of thyroid nodules in distinguishing malignant form benign lesions; 6) the value of percutaneous ethanol injection in the treatment of thyroid or nodal recurrences of thyroid cancer; 7) the relatively benign course of intrathyroid metastases from renal cell carcinoma; 8) the exceedingly rare thyroid paraganglioma, though the rate of reports has increased recently; and 9) the increase in serum calcitonin caused by chronic alcoholism, an increase that cannot be reversed by three weeks of alcohol weaning.
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PMID:Update on thyroid cancer. 1849 Dec 51


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