National Cancer Institute®
Last Modified: June 1, 2002
1
UI - 11772432
AU - Eurelings M; Frijns CJ; Jeurissen FJ
TI -
Painful ophthalmoplegia from metastatic nonproducing parathyroid
carcinoma: case study and review of the literature.
SO - Neuro-oncol 2002 Jan;4(1):44-8
AD - Department of Neurology, University Medical Center, Utrecht, The
Netherlands.
Parathyroid carcinoma is an uncommon malignancy. Of the fewer than 400
cases reported, most have been cases of producing parathyroid carcinoma
with accompanying hypercalcemia. Only 13 patients with nonproducing
parathyroid carcinoma have been described. Nine of these 13 patients had
metastatic disease. We report a patient with i.c. metastasis. Distal
metastases of producing parathyroid carcinoma are treated surgically to
prolong survival and prevent complications of hyperparathyroidism and
hypercalcemia. One half of the patients with producing parathyroid
carcinoma die within 5 years, mostly because of the complications of
hypercalcemia. Nonproducing parathyroid carcinoma compares unfavorably
with producing parathyroid carcinoma in terms of tumor progression and
prognosis. Few data on choice of therapy in nonproducing parathyroid
carcinoma are available. We treated our patient with a combination of
radiotherapy and chemotherapy. Treatment was followed by an unexpectedly
prolonged survival of 31 months after diagnosis of metastatic disease.
2
UI - 11937656
AU - Weis U; Meeking DR; Cummings MH
TI -
Severe osteoporosis and autonomous hyperparathyroidism: making the
numbers add up.
SO - QJM 2002 Apr;95(4):255-7
3
UI - 11879624
AU - Garcia Perez I; Pozo Fidalgo F; Ricarte Perez P; Garcia-Moran M
TI -
[On the isotopic localization of parathyroid adenomas]
SO - Rev Esp Med Nucl 2002 Apr;21(2):126-7
AD - Servicio de Cirugia General II, Hospital Central de Asturias, Spain.
4
UI - 12022577
AU - Kao CL; Chang JP; Lin JW; Lin CC
TI -
Brown tumor of the sternum.
SO - Ann Thorac Surg 2002 May;73(5):1651-3
AD - Department of Thoracic and Cardiovascular Surgery, Chang Gung Memorial
Hospital at Kaohsiung, Kaohsiung Hsien, Taiwan, Republic of China.
sa11421@adm.cgmh.org.tw
The skeletal changes of severe hyperparathyroidism, known as osteitis
fibrosa cystica, are now rarely encountered, because hyperparathyroidism
is currently being diagnosed and treated at an early stage. Herein, a
case of brown tumor of the sternum is reported; our report adds
histologic data on this type of tumor to the literature.
5
UI - 11994364
AU - Corbetta S; Lania A; Filopanti M; Vicentini L; Ballare E; Spada A
TI -
Mitogen-activated protein kinase cascade in human normal and tumoral
parathyroid cells.
SO - J Clin Endocrinol Metab 2002 May;87(5):2201-5
AD - Institute of Endocrine Science, Ospedale Maggiore IRCCS, Milan, Italy
20122.
The calcium-sensing receptor (CaR) activation has recently been shown to
modulate the ERK1 and ERK2 cascade in different cell lines. The present
study investigated this pathway in human normal and tumoral parathyroid
cells. In cells from normal parathyroids and almost all hyperplasia
increasing extracellular calcium concentrations (Ca(o)(2+)) induced a
significant activation of ERK1 and -2, the percent stimulation over
basal activity (at 0.5 mM Ca(o)(2+)) being 545 +/- 140 and 800 +/- 205
in normal cells and 290 +/- 71 and 350 +/- 73 in hyperplasia at 1 and 2
mM Ca(o)(2+), respectively. This effect was mediated by CaR because it
was mimicked by the receptor agonist gadolinium and neomycin. Basal and
Ca(o)(2+)-stimulated ERK1 and -2 activity was nearly abolished by the
PKC inhibitor calphostin C, and PKA changes did not affect ERK1 and -2
activity. PI3K blockade by wortmannin, known to prevent G protein
betagamma subunit effect on ERK1 and -2, induced a 30% reduction of the
Ca(o)(2+)-stimulated ERK1 and -2 activity. Adenomatous cells showed high
PKC-dependent ERK1 and -2 activity in resting conditions that was
unresponsive to high Ca(o)(2+). A role of MAPK on PTH secretion was
suggested by the finding that PD98059, a specific MEK inhibitor,
abolished the inhibitory effect of 1.5 mM Ca(o)(2+) on PTH release from
normal parathyroid cells. In conclusion, these data first demonstrate
that CaR activation, through the PKC pathway and, to a lesser extent,
PI3K, increases ERK1 and -2 activity in normal parathyroid cells and
this cascade seems to be involved in the modulation of PTH secretion by
Ca(o)(2+). Interestingly, this signaling pathway is disrupted in
parathyroid tumors.
6
UI - 11446675
AU - Kikuchi T; Watanobe H; Suda T; Tomiyama T; Masuda M
TI -
Marked uptake of technetium-99m pertechnetate by parathyroid adenoma.
SO - Intern Med 2001 Jun;40(6):506-9
AD - First Department of Internal Medicine, Aomori City Hospital, Katta.
We herewith report an unusual case of primary hyperparathyroidism whose
parathyroid adenoma strongly accumulated technetium (Tc)-99m
pertechnetate. A 41-year-old woman was referred to our department under
the tentative diagnosis of primary hyperparathyroidism. Scintigraphy by
thallium-201 chloride showed homogeneous uptake in the whole thyroid,
whereas Tc-99m image revealed a strong local accumulation in the middle
portion of the right thyroidal lobe. Neck exploration revealed a 12x8x5
mm tumor in the posterolateral region of the right thyroidal lobe, the
pathology of which was parathyroid adenoma. In addition, a small nodule
(8 mm in diameter) with pathological findings revealing follicular
adenoma of the thyroid, was found within the medial portion of the right
thyroidal lobe. Both lesions were removed by surgery, and a
postoperative Tc-99m scintigraphy no longer demonstrated a significant
uptake in the right thyroidal lobe. Since the thyroid adenoma was too
small to be detected by any scintigraphic study and located much closer
to the median line than the site of the marked accumulation of Tc-99m
pertechnetate, it was considered very likely that the parathyroid
adenoma concentrated Tc-99m. Search of literature revealed that there
have been only thirteen cases of parathyroid tumor reported to date
which significantly accumulated Tc-99m pertechnetate. The present
patient represents another rare case of parathyroid adenoma showing sueh
an unusual scintigraphic image.
7
UI - 11980616
AU - Dwight T; Kytola S; Teh BT; Theodosopoulos G; Richardson AL; Philips J;
TI -
Twigg S; Delbridge L; Marsh DJ; Nelson AE; Larsson C; Robinson BG
Genetic analysis of lithium-associated parathyroid tumors.
SO - Eur J Endocrinol 2002 May;146(5):619-27
AD - Cancer Genetics Unit, Kolling Institute of Medical Research, Royal North
Shore Hospital, Sydney, Australia.
OBJECTIVE: The aim of this study was to determine the primary genetic
events that may underlie the formation of parathyroid tumors in patients
with lithium-associated hyperparathyroidism (HPT). METHODS: Comparative
genomic hybridization (CGH), loss of heterozygosity (LOH) and multiple
endocrine neoplasia type 1 gene (MEN1) mutation analysis were used to
analyze twelve parathyroid tumors from nine patients with
lithium-associated HPT. For comparison, CGH was also carried out in a
non-lithium-associated group of thirteen sporadic parathyroid tumors.
RESULTS: A higher prevalence of multiglandular disease in the
lithium-associated HPT patients compared with the idiopathic sporadic
patients was observed (Fisher's exact test, P=0.02). CGH alterations
were detected in four lithium-associated parathyroid tumors, involving
loss at 1p, 11, 15q, 22q and gain of the X chromosome. In addition, one
of these four cases exhibited LOH at 11q13 and was found to contain a
novel somatic MEN1 mutation (c.1193insTAC). Although fewer
lithium-associated parathyroid tumors were shown to contain genetic
alterations compared with the sporadic parathyroid tumors, the changes
detected were those frequently associated with both familial and
sporadic parathyroid tumorigenesis. CONCLUSION: This is, to our
knowledge, the first genetic analysis of parathyroid tumors in
lithium-associated HPT patients. Our data indicated that the majority of
lithium-associated parathyroid tumors do not contain gross chromosomal
alterations and suggest that in most cases the tumorigenic pathway is
independent of MEN1 and genes at 1p34.3-pter and 1q21-q32. It is
possible that other discrete genetic alterations or epigenetic changes,
not screened for in this study, could also be responsible for
parathyroid tumorigenesis in lithium-associated HPT.
8
UI - 12073627
AU - Tanaka M; Itoh K; Matsushita K; Ogawa A; Hirayama H; Tsunoda N;
TI -
Yoshizumi K; Naruse M; Nonoguchi H; Tomita K
[A case of secondary hyperparathyroidism with an ectopic intrathyroid
gland successfully diagnosed and controlled by percutaneous ethanol
injection therapy (PEIT)]
SO - Nippon Jinzo Gakkai Shi 2002 May;44(4):409-13
AD - NTT Nishinippon Kyushu General Hospital, Japan.
Secondary hyperparathyroidism (II HPT) is a major complication in
chronic dialysis patients, and percutaneous ethanol injection therapy
(PEIT) has become a useful alternative treatment for II HPT. However,
the existence of ectopic parathyroid glands is a major problem when
conducting PEIT. Ectopic parathyroid gland accepts 10-35% of II HPT, and
the missing glands cannot be detected consistently by any imaging
techniques, including scintigraphy. Intrathyroid parathyroid gland is as
rare as about 1% and recurrence of missing glands after
parathyroidectomy (PTx) has been reported in some cases. We report here
a 52-year-old female in whom an ectopic parathyroid gland was defected
successfully and intact-PTH controlled by tentative PEIT. At the first
examination, a left parathyroid adenoma and a right thyroid goiter were
pointed out by ultrasonography, CT and scintigraphy. PEIT was applied
twice to the left parathyroid adenoma, but intact-PTH was not decreased.
Ultrasonography, CT, 201Tl-99mTc subtraction scintigraphy and fine
needle aspiration biopsy (FNAB) were performed again to search for the
existence of ectopic glands. The results suggested that the right
intrathyroid tumor was an ectopic parathyroid gland. Consequently,
tentative PEIT was applied to the right intrathyroid tumor, and
successful control of intact-PTH and serum Ca was eventually achieved.
To our knowledge, this is the first reported case of secondary
hyperparathyroidism with an ectopic intrathyroid gland that was
successfully controlled by PEIT. In this case, it was suggested that
tentative PEIT of intrathyroid tumor was a useful method for detecting
an ectopic parathyroid gland.
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