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

Intrathyroid parathyroid adenoma is a rare lesion. Its location is usually achieved by cervical ultrasound and scintigraphy. We present the case of a 48-years old woman admitted for malaise, weight loss, generalized bone pain, and important limitation of hip and scapular-humeral joints mobility. Cervical ultrasound identified a 4 cm nodular mass in the right thyroid lobe. Computed tomography revealed multiple osteolytic lesions in the pelvis, femur, ribs, phalanx, and humerus. Imagery and elevated serum levels of calcium and parathormone led to primary hyperparathyroidism, right parathyroid adenoma and bone "brown tumors". Intraoperatively, the adenoma was found in intrathyroid location. Total right lobectomy was performed. Postoperatively, the patient developed "hungry bone" syndrome requiring prolonged calcium and vitamin D treatment.
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PMID:Ectopic intrathyroid parathyroid adenoma: diagnostic and therapeutic challenges due to multiple osteolytic lesions. Case report. 2189 97

Primary hyperparathyroidism (PHPT) is the most common cause of hypercalcemia in the outpatient population. It is diagnosed in most individuals in the Western world at an asymptomatic stage without signs or symptoms of parathyroid hormone (PTH) calcium excess. Nonspecific symptoms include weakness, malaise, fatigue, and possible mood disturbances, which may be present at the time of diagnosis. The diagnosis of PHPT is confirmed in the presence of hypercalcemia and a normal or elevated PTH level in the absence of conditions that mimic PHPT. Indications for surgery have recently been revised based on international consensus, and surgery is advised in the presence of significant hypercalcemia, impaired renal function, and osteoporosis and in individuals younger than 50yr. The classical complications of PHPT are skeletal fragility, nephrolithiasis, and nephrocalcinosis. Surgery is always appropriate in an individual with confirmed PHPT after excluding conditions that can mimic PHPT and in the absence of contraindications. Individuals with asymptomatic PHPT not meeting the guidelines for surgery or those with contraindications for surgery may be followed and considered for medical management. For those at an increased risk of fragility fracture, antiresorptive therapy may be considered with close monitoring of biochemical data and bone densitometry. Targeted therapy with a calcimimetic agent may be of value in lowering serum calcium and PTH. There are currently no fracture data for the medical options available, and prospective randomized controlled trials are required to confirm the effects of medical therapy on fracture risk reduction in those with asymptomatic PHPT.
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PMID:Medical management of primary hyperparathyroidism. 2337 43

Pathophysiologic mechanisms of malignancy-associated hypercalcemia are varied. The association of neoplasia and primary hyperparathyroidism (PHP) has been illustrated by clinical cases and by epidemiologic studies which have pointed to an increased risk of different malignancies during PHP. The authors report two cases of monoclonal gammapathy and one case of chronic lymphocytic leukemia (CLL) associated with PHP. A 58-year-old man presented with hypercalcemia due to PHP after remission for multiple plasmacytoma was obtained. A 70-year-old man was hospitalized for malaise, studies showed major hypercalcemia and benign monoclonal gammapathy. In the two cases, resolution of hypercalcemia was obtained by parathyroidectomy. The third patient was a 84-year-old woman with CLL who continued to deteriorate despite response to therapy, further studies confirmed hyperparathyroidism Physiopathogenic mechanisms of this association are discussed. The PHP-malignancy association should be considered ifthe symptoms or outcome of anyone of the two diseases are atypic.
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PMID:Primary Hyperparathyroidism and Lymphoproliferative Diseases: Three Case Reports. 2741 5


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