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NCI CANCERLIT® Search: Parathyroid Cancer - March 2002
National Cancer Institute®
Last Modified: March 1, 2002
Table of Contents
1
UI - 11845573
AU - Mannesse CK; van Ouwerkerk BM; Willemse AP
TI -
[Cognitive deterioration in the elderly due to primary
hyperparathyroidism--resolved by parathyroidectomy]
SO - Ned Tijdschr Geneeskd 2002 Jan 26;146(4):188
2
UI - 11848332
AU - Agrawal R; Agarwal A; Kar DK; Agarwal G; Jain M; Krishnani N; Gupta S;
TI -
Mithal A; Mishra SK
Parathyroid carcinoma.
SO - J Assoc Physicians India 2001 Oct;49():990-3
AD - Department of Endocrine Surgery, Sanjay Gandhi Post Graduate Institute
of Medical Sciences, Lucknow, Uttar Pradesh, India.
INTRODUCTION: Parathyroid carcinoma is a rare tumor with an incidence of
0.5 to 4%. Preoperative differentiation from benign adenoma is very
difficult. Several features, though nonspecific, have been used in
differentiating parathyroid carcinoma from the adenoma. MATERIAL AND
METHOD: A retrospective analysis during the period of nine years, four
cases of parathyroid carcinoma were diagnosed on the basis of
per-operative local invasion and on histological evidence of capsular
invasion and vascular invasion. RESULT: We have different observations
to make. Diagnosis of parathyroid carcinoma which was done on the basis
of intra operative suspicion only. One patient died on 6th post
operative day due to development of pancreatitis. At the follow-up of
two years there was no local recurrence or distant metastasis.
CONCLUSION: It is preferable to have a high index of suspicion for
parathyroid carcinoma when these features are present than to miss the
opportunity for surgical cure by failing to consider it in the
differential diagnosis.
3
UI - 11870248
AU - Broadus AE; Braaten KM
TI -
Case records of the Massachusetts General Hospital. Weekly
clinicopathological exercises. Case 7-2002. A 47-year-old woman with
late recurrent hyperparathyroidism.
SO - N Engl J Med 2002 Feb 28;346(9):694-700
AD - Division of Endocrinology and Metabolism, Yale University School of
Medicine, New Haven, CT, USA.
4
UI - 11854692
AU - Civelek AC; Ozalp E; Donovan P; Udelsman R
TI -
Prospective evaluation of delayed technetium-99m sestamibi SPECT
scintigraphy for preoperative localization of primary
hyperparathyroidism.
SO - Surgery 2002 Feb;131(2):149-57
AD - Russell H. Morgan Department of Radiology and Radiological Science,
Division of Nuclear Medicine, The Johns Hopkins Medical Institutions,
Baltimore, MD, USA.
BACKGROUND: Delayed technetium-99m sestamibi single photon emission
computed tomography (SPECT) scans were prospectively analyzed in a large
series of patients with primary hyperparathyroidism. METHODS: Three
hundred thirty-eight patients underwent sestamibi-SPECT and were
explored. Prospective data included preoperative demographics, clinical,
sestamibi, and operative findings, laboratory values, and pathologic and
follow-up laboratory results from all patients. RESULTS: Between 1994
and 2000, 287 unexplored patients (85%) and 51 re-explored patients
(15%) participated. The abnormal parathyroid glands excised from 336 of
338 patients included 299 single adenomas (88%) and 23 double adenomas
(7%), and 14 patients had multigland hyperplasia (4%). Sestamibi SPECT
correctly lateralized 349 of 400 abnormal parathyroid glands, with an
overall sensitivity of 87%, an accuracy of 94%, and a positive
predictive value of 86%. Precise localization occurred in 82% of the
abnormal parathyroid glands. Sestamibi sensitivity was similar in
unexplored (87%) and reoperative (92%) cases; two hundred eighty-six of
299 (96%) solitary adenomas, 38 of 46 (83%) double adenomas, but only 25
of 55 (45%) hyperplastic glands were identified. The mean weight of the
true-positive glands (1252 +/- 1980 mg) was greater than that of the
false-negative glands (297 +/- 286 mg) (P <.005). Three patients had
persistent primary hyperparathyroidism, in spite of the excision of
sestamibi-identified lesions in 2 cases. Follow-up indicated curative
resection in 99% of the unexplored cases and 94% of the remedial cases.
CONCLUSIONS: Sestamibi SPECT is highly accurate for the localization of
parathyroid adenomas in unexplored and re-explored cases, where it is
often the only imaging required. Its sensitivity is limited in
multiglandular disease.
5
UI - 11854713
AU - Hodin R
TI -
The value of sestamibi scans.
SO - Surgery 2002 Feb;131(2):238-9
6
UI - 11819104
AU - Cupisti K; Dotzenrath C; Simon D; Roher HD; Goretzki PE
TI -
Therapy of suspected intrathoracic parathyroid adenomas. Experiences
using open transthoracic approach and video-assisted thoracoscopic
surgery.
SO - Langenbecks Arch Surg 2002 Jan;386(7):488-93
AD - Klinik fur Allgemein- und Unfallchirurgie, Universitatsklinikum,
Heinrich-Heine-Universitat Dusseldorf, Moorenstrasse 5, 40225
Dusseldorf, Germany. cupisti@uni-duesseldorf.de
BACKGROUND AND AIMS: Ectopic mediastinal parathyroid adenoma as a cause
of primary hyperparathyroidism (pHPT) can normally be resected from
conventional collar incision. In rare cases with adenomas deeper in the
chest, a transthoracic approach is necessary. PATIENTS/METHODS: We
report our experience of 19 patients with suspected mediastinal
parathyroid adenomas from a total of 1035 patients with pHPT who were
operated on between 1986 and 2000 using an open approach (sternotomy or
thoracotomy) or video-assisted mediastinal or thoracoscopic surgery
(VAMS/VATS). RESULTS: Fourteen patients underwent an open approach with
a success rate of 71% (10 of 14). Four patients remained hypercalcaemic.
There were four complications in three patients: three permanent
recurrent nerve palsies and one chylus fistula, requiring further
surgery. VATS was successful in three of four patients with conversion
to sternal splitting because of a false-negative frozen section in one
patient. Another patient had parathyroid adenoma retrosternally which
could not be resected by means of VAMS and had to be excised using a
transsternal approach. There were no complications of minimal invasive
procedures. All five patients were normocalcaemic after the operation.
CONCLUSION: Ectopic parathyroid adenomas not resectable by means of a
collar incision are rare causes of pHPT and comprise 1.25% of all
patients with pHPT in our series. For these patients, VATS revealed an
alternative to conventional open procedures. In questionable cases,
however, the collar incision should precede the VATS procedure.
7
UI - 11822866
AU - Yoshida T; Nagahama T; Maruyama M; Ebuchi M
TI -
Thoracoscopically managed parathyroid adenoma in the upper anterior
mediastinum.
SO - Surg Laparosc Endosc Percutan Tech 2001 Dec;11(6):385-8
AD - Department of Surgery, Tokyo Metropolitan Ohkubo Hospital, Japan.
t.yoshida@libra.bekkoame.ne.jp
We thoracoscopically managed parathyroid adenoma of the upper anterior
mediastinum in a 29-year-old man. He had a backache and was found to
have bilateral ureteric stones, hypercalcemia, and extremely increased
parathyroid hormone levels. 99mTc-methoxyisobutyl isonitrile
scintigraphy showed an accumulation area projected onto the right
thyroid lobe and the upper mediastinum. A diagnosis of primary
hyperparathyroidism secondary to double adenomas was made. The patient
then underwent surgical intervention. With the patient under general
anesthesia with one-lung ventilation, a reddish brown adenoma of an
upper mediastinum was removed thoracoscopically with three trocars,
whereas the right superior parathyroid adenoma was excised by a standard
open cervical procedure. Conventionally, the mediastinal parathyroid
adenoma was removed by an open approach and was associated with
perioperative distress to the patient. If the exact location of the
mediastinal lesion is established, thoracoscopic excision of these
lesions is feasible and is strongly recommended.
8
UI - 11740057
AU - Kar DK; Agarwal G; Mehta B; Agarwal J; Gupta RK; Dhole TN; Mishra SK
TI -
Tuberculous granulomatous inflammation associated with adenoma of
parathyroid gland manifesting as primary hyperparathyroidism.
SO - Endocr Pathol 2001 Fall;12(3):355-9
AD - Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of
Medical Sciences, Lucknow, India.
A 36-year-old female presented with generalized bone pain, muscular
weakness and enlarged cervical lymph nodes. The biochemical findings and
skeletal survey was suggestive of primary hyperparathyroidism (PHPT). CT
of neck and thorax showed enlarged multiple lymph nodes in the cervical
and superior mediastinal region. With a diagnosis of PHPT she underwent
cervical exploration and excision of enlarged right inferior parathyroid
gland along with biopsy of nodes were done. Histopathology revealed the
features of right parathyroid adenoma with few foci of epithelioid
granuloma and granulomatous lymphadenitis. AFB smear and culture
sensitivity was negative. A positive PCR for Mycobacterium tuberculosis
of the homogenates of parathyroid tumor confirmed tuberculous
inflammation within the parathyroid adenoma. To the best of our
knowledge this is the first reported case of parathyroid adenoma
associated with tuberculous pathology in a case of PHPT.
9
UI - 11881169
AU - Scheiner J
TI -
Retrotracheal parathyroid adenoma.
SO - Med Health R I 2002 Feb;85(2):63
AD - Department of Diagnostic Imaging, Rhode Island Hospital, USA.
JScheiner@lifespan.org
10
UI - 11834430
AU - Garcia JL; Tardio JC; Gutierrez NC; Gonzalez MB; Polo JR; Hernandez JM;
TI -
Menarguez J
Chromosomal imbalances identified by comparative genomic hybridization
in sporadic parathyroid adenomas.
SO - Eur J Endocrinol 2002 Feb;146(2):209-13
AD - Centro de Investigacion del Cancer, Universidad de Salamanca-CSIC,
Salamanca, Spain.
OBJECTIVE: To identify chromosomal gains and losses in sporadic
parathyroid adenomas (PAs). METHODS: Fourteen sporadic PAs were studied
by comparative genomic hybridization (CGH). RESULTS: The fourteen
studied PAs showed chromosomal imbalances. All cases except one
exhibited two or more abnormalities. Chromosomal gains were found in all
cases, and three cases (21%) also presented chromosomal losses. Genomic
amplification was not observed. Chromosome 9 was involved in ten cases.
Recurrent genetic gain was found on 9p22-24 and on 9q34, each in 6 of 14
cases (43%). Other recurrent gains included Xq26 in 6 PAs (43%) and
4q21-28 and 8p22-23, each in 4 of 14 cases (29%). Regions of recurrent
genetic loss involved whole chromosome 11 and 20q12-13, each in 2 of 14
cases (14%). CONCLUSIONS: Our findings show chromosomal imbalances in
all sporadic PAs studied by CGH, partly confirming previous reports,
with the exception that we observed more chromosomal gains than losses.
Several regions (9p22-24, 9q34, Xq26, 4q21-28, and 8p22-23) probably
deserve further investigation in order to discard the presence of genes
involved in parathyroid tumorigenesis.
11
UI - 11874419
AU - Villablanca A; Farnebo F; Teh BT; Farnebo LO; Hoog A; Larsson C
TI -
Genetic and clinical characterization of sporadic cystic parathyroid
tumours.
SO - Clin Endocrinol (Oxf) 2002 Feb;56(2):261-9
AD - Department of Molecular Medicine, Karolinska Hospital, Stockholm,
Sweden. andrea.villablanca@cmm.ki.se
OBJECTIVE: The hyperparathyroidism--jaw tumour (HPT--JT) syndrome is one
of the familial disorders characterized by primary hyperparathyroidism
and has been linked to the chromosomal region of 1q32--q21. The
parathyroid tumours related to this syndrome have shown loss of
wild-type alleles at this locus suggesting that inactivation of a tumour
suppressor gene might be responsible for the disease. In the majority of
these tumours cysts are a prominent feature. By loss of heterozygosity
(LOH) studies, we investigated the region of interest in an attempt to
clarify its possible role in a series of cystic sporadic parathyroid
adenomas. DESIGN AND SUBJECTS: A total of 30 patients diagnosed with
sporadic hyperparathyroidism were included in the study, genotyped with
17 polymorphic microsatellite markers at chromosome 1q, and additional
markers from 1p and 11q13 which are commonly involved in sporadic
parathyroid tumours. The cystic parathyroid tumours were characterized
clinically, and immunohistochemistry against PTH was carried out to
confirm the parathyroid origin of the cysts. RESULTS: LOH was found in
six of 30 tumours (20%) on 1q, six of 30 tumours (20%) on 1p and five of
30 tumours (17%) on 11q13. We found a significant correlation between
allelic alterations and the clinical parameters, tumour weight and PTH.
Furthermore, we found a significant difference between tumour weight and
PTH in cases of cystic parathyroid tumours compared with unselected
sporadic cases. CONCLUSIONS: These results suggest that cystic
parathyroid tumours might represent a new subgroup among parathyroid
tumours based on the genetic and clinical findings. Loss of
heterozygosity at 1q further supports the presence of a tumour
suppressor gene at this locus.
12
UI - 11859834
AU - Yamamoto T; Matsumura A; Nose T
TI -
Intracranial metastatic parathyroid carcinoma: case report.
SO - Neurosurgery 2001 Dec;49(6):1487
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