Tc-99m methoxyisobutylisonitrile (MIBI) and Tl-201/technetium subtraction scintigraphy have been used for localization of abnormal parathyroid gland. The uptake mechanism of tracers has been postulated to be increased cellular density and vascularity, or dependent on the presence of mitochondria-rich cells. However, the uptake of these tracers was not specific for abnormal parathyroid gland. The author report a case of thymic carcinoma that would have been mistaken for carcinoma of parathyroid because of Tc-99m MIBI and Tl-201 uptake.
Parathyroid Glands ; Radionuclide Imaging ; Thymoma*

Diagnosis, Differential ; Humans ; Parathyroid Glands

The frequency of hyperparathyroidism has slowly increased recently with routine measurement of serum calcium and increasing awareness by the public of the disease. The success of parathyroid surgery depends on the identification and removal of all hyperactive parathyroid tissue. Advances in preoperative imaging, such as high resolution ultrasonography and Tc-99m sestamibi, plays a major role in the targeted operative approach that does not disturb the normal parathyroid glands. Tc 99m sestamibi scanning is generally viewed as the gold standard for preoperative parathyroid localization with high sensitivity and specificity, while the intraoperative measurement of intact parathyroid hormone (iPTH )provides the surgeon with a quantitative test that predicts the postoperative serum calcium level and can justify early closure or further exploration for hyperfunctioning parathyroid gland. Therefore, the combination of Tc-99m sestamibi and rapid intraoperative iPTH measurement enable minimally invasive techniques for multiple parathyroid lesions. The combination of Tc-99m sestamibi and intraoperative iPTH monitoring, indispensable for securing operative success, represents an accurate and effective diagnostic tools. The authors experienced a case that proved the combination of Tc-99m sestamibi and rapid intraoperative PTH monitoring useful and made a report with a review of literature.
Calcium ; Hyperparathyroidism ; Parathyroid Glands ; Parathyroid Hormone ; Parathyroidectomy* ; Sensitivity and Specificity ; Ultrasonography

Humans ; Parathyroid Neoplasms/genetics* ; Molecular Biology ; Parathyroid Glands

Studying rate of getting parathyroid gland function disorder and looking relations between parathyroid gland function and blood Calci, phosphorus level in 37 patients with chronic renal failure at stage 4 at Kidney Department in Hue National hospital. Method: interruption. The result showed that: 59,5% patients have PTHi uper 200pg/ml suggesting a secondary hyperoarathyroidism. No patient has adynamic bone disease. There is an inverse-proportional correlation between phosphatemia and PTH
Parathyroid Glands ; Kidney Failure, Chronic ; Dialysis

BACKGROUND AND OBJECTIVES: To preserve the parathyroid gland during thyroidectomy, understanding of its anatomy and physiology is essential. Parathyroid autotransplantation can be performed to restore the function of parathyroid gland. However, the efficacy of parathyroid autotransplantation is still debatable. The aim of this study was to analyze the frequency of hypoparathyroidism following thyroidectomy and evaluate the efficacy of parathyroid autotransplantation. SUBJECTS AND METHOD: We analyzed 449 patients who underwent thyroidectomy from January 2006 to June 2010. A total of 419 patients underwent total thyroidectomy, while 30 patients underwent unilateral lobectomy. Among the total thyroidectomy group, 96 patients underwent unilateral central neck dissection and 186 patients underwent bilateral central neck dissection. We analyzed the frequency of hypoparathyroidism according to the extent of thyroidectomy and central neck dissection, and parathyroid gland autotransplantation. RESULTS: Transient hypoparathyroidism occurred in 20% of lobectomy patients and 54.6% of the entire thyroidectomy group. Permanent hypoparathyroidism occurred only in 7.2% of the entire thyroidectomy group. Transient and permanent hypoparathyroidism occurred in 47.4% and 6.5%, respectively, of the patients without central neck dissection, in 54.0% and 7.3%, respectively, of the patients with unilateral central neck dissection, and 60.2% and 7.5%, respectively, of the patients with bilateral central neck dissection. Parathyroid autotransplantation was performed in 29 patients of 105 patients whose one or more parathyroid glands were removed inadvertently, and permanent hypoparathyroidism did not occur among those patients. CONCLUSION: The frequency of transient hypoparathyroidism was increased according to the extent of thyroidectomy and central neck dissection. Parathyroid autotransplantation might be effective in minimizing permanent hypoparathyroidism.
Humans ; Hypoparathyroidism ; Neck Dissection ; Parathyroid Glands ; Thyroidectomy

Intra-operative parathyroid hormone (IOPTH) assay is a useful tool to confirm complete excision of all hyper-functioning parathyroid gland tissue. In this report, we describe a case with successful localization of distant metastasis in a patient with parathyroid carcinoma using the IOPTH assay. A 53-year-old man presented to our clinic with a serum calcium level of 11.8 mg/dL and an intact PTH level of 233.3 pg/mL. He had been treated for parathyroid carcinoma eleven years ago. Two suspected metastatic lesions were detected on the chest computed tomography. Due to the vastly different surgical field necessary to excise each lesion, we preferentially removed only one lesion and we monitored the other remaining suspected lesion without resection via IOPTH assay. Six months later, the patient's serum calcium and intact PTH levels remained within their normal ranges. To the best of our knowledge, this is the first case to effectively utilize IOPTH assay for the management of metastatic parathyroid carcinoma.
Calcium ; Humans ; Middle Aged ; Neoplasm Metastasis ; Parathyroid Glands ; Parathyroid Hormone ; Parathyroid Neoplasms ; Reference Values ; Thorax

Acute pancreatitis caused by primary hyperparathyroidism-induced hypercalcemia is a rare condition, as acute pancreatitis is typically associated with a decrease in serum calcium levels. If hypercalcemia is present in a patient with acute pancreatitis, the possibility of hyperparathyroidism should be considered, and parathyroid hormone levels should be evaluated and the parathyroid gland imaged. We present a case of a 48-year-old male with acute recurrent pancreatitis caused by hyperparathyroidism. Initially, the acute pancreatitis improved after conservative therapy. However, the patient relapsed 1 month later. The patient had hypercalcemia and was diagnosed with parathyroid adenoma. He underwent surgical resection of the parathyroid adenoma and recovered. After 24 months of the treatment, there was no recurrence of the hypercalcemia or pancreatitis.
Calcium ; Humans ; Hypercalcemia ; Hyperparathyroidism ; Male ; Middle Aged ; Pancreatitis ; Parathyroid Glands ; Parathyroid Hormone ; Parathyroid Neoplasms ; Recurrence

One of the common complications of parathyroid surgery is the development of postoperative hypocalcemia. Hypocalcemia may result from the redistribution of serum calcium as well as the insufficient supply of parathyroid hormone from the parathyroid tissues remaining after the parathyroidectomy. Hungry bone syndrome is postoperative hypocalcemia that takes place due to rapid redistribution of serum calcium to the bone and requires a long-term medical management. We have experienced a 34-year-old man who presented brown tumor in the left humerus and developed hungry bone syndrome after resection of a parathyroid gland adenoma. We report this case with a review of the literature.
Adenoma ; Adult ; Calcium ; Humans ; Humerus ; Hypocalcemia ; Parathyroid Glands ; Parathyroid Hormone ; Parathyroid Neoplasms* ; Parathyroidectomy

Parathyroid carcinoma is an uncommon endocrine tumor. Its usual clinical presentation is that of primary hyperparathyroidism with elevated serum calcium and parathyroid hormone levels. Nonfunctioning carcinoma of the parathyroid gland with normal serum calcium levels is very rare and more aggressive. Histologically, the neoplastic cells may be of variable size and shape but are usually uniform and not too dissimilar from normal parathyroid cells. There is a general agreement that a diagnosis of carcinoma based on cytologic detail is unreliable, and local invasion and metastasis constitute the only reliable criteria of malignancy. In both functional and nonfunctional carcinoma, early surgery has proven to be the only curative treatment approach whereas both chemotherapy and radiation therapy fail to produce systemic or regional benefit when used alone. En bloc excision of primary lesion with removal of any involved structures should be performed. This paper is a case report of a nonfunctioning parathyroid carcinoma and a review of the literature.
Calcium ; Diagnosis ; Drug Therapy ; Hyperparathyroidism ; Hyperparathyroidism, Primary ; Neoplasm Metastasis ; Parathyroid Glands ; Parathyroid Hormone ; Parathyroid Neoplasms*