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Query: UMLS:C0221002 (primary hyperparathyroidism)
 4,921 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Carcinoma of the parathyroid glands is a rare disease which occurs only in 0.5 to 4 percent as the cause of a primary hyperparathyroidism. One third of the tumors are hormonally inactive. A review of the diagnosis, course and possibilities of treatment of this disease is given with reference to the literature. Observations of 2 cases show the special problems of diagnosis and simple possibilities for the satisfactory treatment of small tumors. Followup examinations of both patients after a year showed no evidence of a relapse.
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PMID:[Parathyroid carcinoma (author's transl)]. 80 40

Primary hyperparathyroidism was thought 30 years ago to be a rare disease, and the diagnosis was most often made in patients presenting with either bone disease or kidney stones. Today the minority of patients with hyperparathyroidism present with such symptoms, a fact accounted for by the introduction into general medical practice three decades ago of laboratory technology for efficiently determining the serum concentrations of various blood minerals, including calcium. Hypercalcemia was detected more frequently, and it was realized that most patients with hyperparathyroidism either had minor symptoms, such as constipation, polyuria, tiredness, and muscle weakness, or they were "asymptomatic" and indistinguishable from normal subjects. It was thought that primary hyperparathyroidism was a progressive disease and that sooner or later all patients would become symptomatic and require parathyroidectomy. Since this operation was curative in a high percentage of cases, it was recommended for virtually all patients once the diagnosis was established. In this contribution the long-term benefits of parathyroidectomy in patients with and without symptoms from primary hyperparathyroidism are reviewed. It is concluded that a multicenter prospective randomized trial is needed to resolve the indications for operative and nonoperative management of patients with this disease.
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PMID:Surgical therapy of patients with primary hyperparathyroidism: long-term benefits. 176 66

Acute primary hyperparathyroidism is a rare disease with a high mortality rate in some series. Between 1960 and 1986, 1000 patients were treated for primary hyperparathyroidism, among them 59 patients with acute hyperparathyroidism. All these patients were successfully operated on; none of them died before surgery. This study reveals the importance of resuscitation and urgent surgery. It is necessary to rehydrate, to correct electrolyte disorders and to lower serum calcium levels, but it is not necessary to obtain normal serum calcium levels before surgery.
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PMID:Acute primary hyperparathyroidism: experience of 59 cases. 280 4

We present here a series of seven children with primary hyperparathyroidism caused by parathyroid adenoma. Chief cells were the primary element in six patients and water-clear cells in one patient. A brief review of the literature on primary hyperparathyroidism in children is included. Emphasis is placed on the clinical characteristics of this rare disease in children.
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PMID:Primary hyperparathyroidism in children. 371 90

We collected 60 cases of parathyroid carcinoma, which was a rare disease of primary hyperparathyroidism, from 1980 to 1989, at several institutes in Japan by a questionnaire. The incidence of parathyroid carcinoma among the cases of the primary hyperparathyroidism in Japan was 4.8%, which was a little higher than that in the western countries. Most of the patients with parathyroid carcinoma show bone disease, high level of serum calcium and palpable anterior neck mass. Echogram is useful for the diagnosis of parathyroid carcinoma and its localization. Cure of the disease depends on the initial operation methods. En bloc resection of the tumor should be performed in each suspected case of a parathyroid carcinoma. The incidence of distant metastasis was 24%, and local recurrence 20% in Japan. Compared with the western countries, the lower incidence of local recurrence in Japan may be due to the operation method. The resection of local recurrence or distant metastases is effective for the control of recurrent hypercalcemia. We should always consider parathyroid carcinoma at the time of diagnosis and treatment of the patients with primary hyperparathyroidism.
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PMID:[Parathyroid carcinoma]. 775 83

Primary hyperparathyroidism is a rare disease in children and is characterized by conspicuous skeletal and renal changes. A 12 year old male patient presented with symptoms of polydipsia, polyuria, general weakness, nausea, and vomiting which had begun 3 months earlier, and showed typical laboratory findings of primary hyperparathyroidism. Confirmatory diagnosis was made by elevated parathyroid hormone concentration in serum, technetium-thallium subtraction scan imaging method and histopathologic finding of chief cell hyperplasia. The laboratory findings revealed elevated levels of BUN, creatinine and decreased GFR. Kidney biopsy showed typical calcium deposits in tubules with marked tubulointerstitial infiltration. After subtotal parathyroidectomy, clinical findings improved remarkably.
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PMID:A case of primary hyperparathyroidism with hypercalcemic nephropathy in children. 799 97

Primary hyperparathyroidism is a rare disease of childhood. The condition is even rarer in the neonatal and infant stages. The disease, with its main manifestation-hypercalcemia-often is fatal. The authors successfully treated a 2.5-month-old boy who had primary parathyroid hyperplasia. The patient had recurrent pneumonia and failure to thrive. Blood test results showed an abnormally high level of calcium, which was resistant to medical therapy. Further investigations showed high levels of parathyroid hormone. The patient underwent neck exploration, which showed hyperplasia of the all four parathyroid glands. Total parathyroidectomy was performed, with one gland being autotransplanted to the deltoid muscle. The patient had an immediate hypocalcemic period, followed by normocalcemia. In light of the present case and others in the Literature, the authors recommended total parathyroidectomy followed by autotransplantation of a gland to an accessible muscle.
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PMID:Primary hyperparathyroidism in infancy: a case report. 870 21

Parathyroid carcinoma is a very rare disease occurring in less than 2-3% of all the cases showing clinical features of primary hyperparathyroidism. Several histological markers have been used for distinguishing between benign and malignant tumors of the parathyroid glands. However, most of these markers are not easily applicable and clinical prognosis cannot be predicted by histopathological criteria alone. A recent study has drawn attention to the role of the cell cycle associated antigen Ki-67 detected by MIB-1 monoclonal immunocytochemistry in parathyroid tumors: in fact, Ki-67 seems to be a valuable marker of malignancy in such tumors since it permits an easy detection of proliferating and dividing cells. Here we report in detail a case of severe recurrent hyperparathyroidism in a 51-year-old female patient undergoing regular hemodialysis treatment. In the surgical specimens of the parathyroid glands, the tumor proliferative fraction of 56, expressed as the number of Ki-67-positive nuclei per thousand cells, and the mean mitosis count of 0.5, expressed as the percentage of the total amount of Ki-67 positive nuclei, support the diagnosis of parathyroid carcinoma despite the scanty amount of microscopical signs considered characteristic of malignancy, i.e. extensive thick fibrous bands or prominent nucleoli. To our knowledge this paper is the first clinical report that supports the diagnostic role of the cell cycle associated antigen Ki-67 in parathyroid carcinoma in a case of secondary hyperparathyroidism in a patient undergoing hemodialysis.
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PMID:Recurrent secondary hyperparathyroidism due to parathyroid carcinoma: usefulness of Ki-67 immunostaining in the diagnosis of a malignant parathyroid tumor. 895 8

Primary hyperparathyroidism (PHP) is a rare disease that must be suspected in all the cases of recurrent calcium nephrolithiasis, and that may be totally corrected by surgery. The imaging techniques permit to locate the hyperplastic gland or adenoma before intervention, but their usefulness in patients without a history of previous neck surgery is still debated. Several imaging techniques have been proposed with the aim of locating parathyroid hyperfunctioning glands, including high resolution sonography (US) with color-Doppler (CD), scintigraphy, computed tomography (CT) and magnetic resonance imaging (MRI). We report here a case of recurrent calcium oxalate nephrolithiasis sustained by PHP, which demonstrates how US coupled with CD and echocontrast enhancement is useful in the preoperative location of parathyroid glands. US is the first choice technique in the evaluation of PHP because it is less expensive and useful in detailing lesions of the neck when carried out by a skilled operator. CD should be regarded as a useful complement of US enhancing its sensitivity (80 vs 90%) especially in the cases of associated thyroid gland diseases. Tc-99m SESTAMIBI scintigraphy coupled with MRI is mandatory in high risk surgical patients, namely in those undergoing repeated neck surgery. In conclusion, considering that surgeon must explore all the four parathyroid glands (because of the possibility of multiple adenomas or hyperplasia) a well definite location of the adenomatous lesion may reduce the risks and the time of intervention, and allow the use of alternative procedures, such as videoscopic surgery. On this view and in terms of economy, only US and CD coupled with Tc-99 SESTAMIBI scintigraphy should be considered before surgery.
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PMID:Color-Doppler in the imaging work-up of primary hyperparathyroidism. 1049 72

Parathyroid cancer is a rare disease, causing 0.5% to 5.2% of primary hyperparathyroidism cases. Hyperparathyroidism accompanying a cancer is usually more severe with richer clinical symptomatology then hyperparathyroidism in the course of benign lesions. Every palpable neck tumour with high blood plasma calcium level should suggest the presence of parathyroid cancer. Development of cancer is slow but life prognosis depends on the extent of the first surgery. The prognosis is most favourable in case of 'en bloc' resection of tumour during the first surgical procedure. Therefore, diagnosis of cancer before operation is very important. If the surgery fails, the treatment should be aimed at lowering hypercalcaemia, which is the most common cause of the fatal sequel.
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PMID:[Parathyroid cancer]. 1087 Apr 12


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