BACKGROUND Parathyroid carcinoma(PC)is a difficult-to-diagnose rare disease with low incidence.Relatively accurate preoperative diagnosis is very important in choosing surgical methods and patient prognosis.CASE SUMMA...BACKGROUND Parathyroid carcinoma(PC)is a difficult-to-diagnose rare disease with low incidence.Relatively accurate preoperative diagnosis is very important in choosing surgical methods and patient prognosis.CASE SUMMARY This study reported the clinical diagnosis and treatment of a rare patient with PC located in the thyroid gland and provided a case reference for the diagnosis and treatment of PC.A case of a 64-year-old male patient who presented to our hospital with systemic muscle and joint pain and palpitations is outlined.Subsequently,the patient was admitted to the Department of Nephrology for the treatment of“multiple myeloma nephropathy pending investigation”.The patient was diagnosed with“primary hyperparathyroidism and hypercalcemic crisis”using thyroid color ultrasound.CONCLUSION The intraoperative frozen section report considered the parathyroid tumor.Surgical tumor resection was promptly performed,and the diagnosis of PC was confirmed.展开更多
BACKGROUND Parathyroid carcinoma(PC)is a rare,slow-growing malignant tumor and a rare cause of primary hyperfunctioning of the parathyroid,with a highly variable clinical course,depending on the aggressiveness of the ...BACKGROUND Parathyroid carcinoma(PC)is a rare,slow-growing malignant tumor and a rare cause of primary hyperfunctioning of the parathyroid,with a highly variable clinical course,depending on the aggressiveness of the individual tumor and the degree of hypercalcemia.CASE SUMMARY The aim of this report is to summarize the diagnosis and treatment of three cases of PC and to review and conclude aspects regarding the three collected cases with reference to other relevant cases to explore the value of ultrasound in the diagnosis of PC.All three patients had hypercalcemia,consisting of a high serum calcium level and a high level of parathyroid hormone that was>2-fold(even>30-fold)of the normal upper limit.The ultrasonographic findings of the parathyroid gland showed that the glands were all>30 mm,and the internal echo was uneven.All patients underwent surgery.PC in three cases was confirmed by routine histopathology and immunohistochemistry.CONCLUSION As clinical signs and laboratory results are nonspecific,it is difficult to diagnose PC preoperatively,so imaging examinations are often needed.展开更多
A 24-year-old female patient with parathyroid carcinoma,the rarest endocrine malignancy,had two pregnancies.In the first pregnancy,she had severe nausea and fatigue.Hypercalcemia and hyperparathyroidism were diagnosed...A 24-year-old female patient with parathyroid carcinoma,the rarest endocrine malignancy,had two pregnancies.In the first pregnancy,she had severe nausea and fatigue.Hypercalcemia and hyperparathyroidism were diagnosed in the postpartum period.Hyperemesis gravidarum masked a diagnosis of hypercalcemia.Neck ultrasound and Tc-99 m sestamibi found an enlarged lower right parathyroid gland.The gland was surgically removed,and an initial pathology report described atypical adenoma.Shortly afterward,she became pregnant again.During the second pregnancy,her calcium level was frequently controlled but was always in the normal range.Normocalcemia is explained by the specific physiology of pregnancy accompanied by hemodilution,hypoalbuminemia and maternal hypercalciuria(mediated by increased glomerular filtration).During lactation,calcium levels rose,and a newneck ultrasound showed a solitary mass in the area of prior surgery and an enlarged pretracheal lymph node.Fine needle aspiration of the solitary mass and node showed parathyroid carcinoma cells.The tumor mass was resected en bloc with the contiguous tissues and surrounding lymph nodes(pathology report; parathyroid carcinoma with metastases).Over the next five years,four consecutive surgeries were performed to remove malignant parathyroid tissue,lymph nodes and local metastases.Following the surgical procedures,no hypocalcemia was observed.More serious hypercalcemia recurred; the calcium level was difficult to control with a combination of pamidronate,cinacalcet and loop diuretic.No elements of multiple endocrine neoplasia were present.展开更多
BACKGROUND Pituitary apoplexy represents one of the most serious,life threatening endocrine emergencies that requires immediate management.Gonadotropin-releasing hormone agonist(GnRHa)can induce pituitary apoplexy in ...BACKGROUND Pituitary apoplexy represents one of the most serious,life threatening endocrine emergencies that requires immediate management.Gonadotropin-releasing hormone agonist(GnRHa)can induce pituitary apoplexy in those patients who have insidious pituitary adenoma coincidentally.CASE SUMMARY A 46-year-old woman,with a history of hypertension and menorrhagia was transferred to our hospital from a secondary care hospital after complaints of headache and vomiting,with loss of consciousness 5 min after an injection of GnRHa.The drug was prescribed by her gynecologist due to the presence of uterine myomas.The clinical neurological examination revealed right cranial nerve III palsy,ptosis and movement limitation of the right eye.Our first clinical consideration was a pituitary apoplexy.Blood hormonal analysis revealed mild hyperprolactinemia and high follicle stimulating hormone level;PTH and calcium was high with glomerular filtration rate mildly to moderately decrease.A computed tomography scan,revealed an enlarged pituitary gland(3.5 cm)impinging upon the optic chiasm with bone involvement of the sella.Following contrast media administration,the lesion showed homogeneous enhancement with high-density focus that suggests hemorrhagic infarction of the tumor.Transsphenoidal endoscopic surgery was perfomed and adenomatous tissue was removed.Immunohistochemistry was positive for luteinizing hormone(LH)and follicular-stimulating hormone(FSH).A solid hypoechoic nodule(14 mm x 13 mm x 16 mm)was found in the caudal portion of the right thyroid lobe after a parathyroid ultrasound.A genetic test of Multiple Endocrine Neoplasia type 1(MEN1)was negative.A right lower parathyroidectomy was performed and the pathologic study showed the presence of an encapsulated parathyroid carcinoma of 1.5 cm.A MEN type 4 genetic test was performed result was negative.CONCLUSION This case demonstrates an uncommon complication of GnRH agonist therapy in the setting of a pituitary macroadenoma and the casual finding of parathyroid carcinoma.It also highlights the importance of suspecting the presence of a multiple endocrine neoplasia syndrome and to carry out relevant genetic studies.展开更多
Parathyroid carcinoma is an extremely rare malignant tumor,composed primarily of vacuolated principal cells,but may also be composed of eosinophils.The exact etiology and pathogenesis of parathyroid carcinoma is unkno...Parathyroid carcinoma is an extremely rare malignant tumor,composed primarily of vacuolated principal cells,but may also be composed of eosinophils.The exact etiology and pathogenesis of parathyroid carcinoma is unknown,and head and neck radiation exposure,chronic stimulation from renal failure,and familial syndromes can lead to the development of parathyroid carcinoma.Most parathyroid carcinoma is difficult to distinguish from benign HPT and is often diagnosed only when there is a recurrence of hypercalcemia several years later,which can manifest as weight loss,extreme fatigue,anorexia,and muscle atrophy.At present,surgical resection remains the primary treatment.In this case,the patient underwent initial surgery for primary hyperparathyroidism and was subsequently diagnosed with parathyroid carcinoma.During the 8 years of follow-up,the patient underwent 7 surgeries in combination with radiation therapy,chemotherapy and targeted medications.Although the neck tumor was cured,the patient died of complications related to hypercalcemia.We will review the literature on the combination of surgery,radiotherapy,chemotherapy,and targeted drug therapy in order to improve the diagnosis and treatment of parathyroid carcinoma.展开更多
Parathyroid carcinoma （PC） is a rare neoplasm that accounts for 0. 1%-5% of primary hyperparathyroidism cases. Hyperparathyroidism-induced hypercalcemic crisis （HHC） is sometimes due to a single PC.1 However,
Objective The aim of the study was to investigate the effect of parathyroid hormone(PTH) on the apoptosis of human medullary thyroid carcinoma(MTC) cells.Methods In vitro cultured medullary thyroid carcinoma cell line...Objective The aim of the study was to investigate the effect of parathyroid hormone(PTH) on the apoptosis of human medullary thyroid carcinoma(MTC) cells.Methods In vitro cultured medullary thyroid carcinoma cell lines were treated with parathyroid hormone and parathyroid hormone receptor-monoclonal antibody,and the apoptosis of cells was detected by flow cytometry.Results The cell morphology changed significantly after treatment based on the observation using the inverted phase-contrast microscope.Various concentrations of parathyroid hormone and parathyroid hormone receptor-monoclonal antibody effectively induced apoptosis in a time-and concentrationdependent manner.When the concentration of parathyroid hormone was 2.0 μmol/L and that of parathyroid hormone receptor-monoclonal antibody was 1.0 μmol/L,the apoptotic rate was 13.24% and 20.78%,respectively,representing a statistically significant difference from that of the control cells(P < 0.05).Conclusion PTH plays a role in inducing apoptosis of human MTC cells.展开更多
文摘BACKGROUND Parathyroid carcinoma(PC)is a difficult-to-diagnose rare disease with low incidence.Relatively accurate preoperative diagnosis is very important in choosing surgical methods and patient prognosis.CASE SUMMARY This study reported the clinical diagnosis and treatment of a rare patient with PC located in the thyroid gland and provided a case reference for the diagnosis and treatment of PC.A case of a 64-year-old male patient who presented to our hospital with systemic muscle and joint pain and palpitations is outlined.Subsequently,the patient was admitted to the Department of Nephrology for the treatment of“multiple myeloma nephropathy pending investigation”.The patient was diagnosed with“primary hyperparathyroidism and hypercalcemic crisis”using thyroid color ultrasound.CONCLUSION The intraoperative frozen section report considered the parathyroid tumor.Surgical tumor resection was promptly performed,and the diagnosis of PC was confirmed.
文摘BACKGROUND Parathyroid carcinoma(PC)is a rare,slow-growing malignant tumor and a rare cause of primary hyperfunctioning of the parathyroid,with a highly variable clinical course,depending on the aggressiveness of the individual tumor and the degree of hypercalcemia.CASE SUMMARY The aim of this report is to summarize the diagnosis and treatment of three cases of PC and to review and conclude aspects regarding the three collected cases with reference to other relevant cases to explore the value of ultrasound in the diagnosis of PC.All three patients had hypercalcemia,consisting of a high serum calcium level and a high level of parathyroid hormone that was>2-fold(even>30-fold)of the normal upper limit.The ultrasonographic findings of the parathyroid gland showed that the glands were all>30 mm,and the internal echo was uneven.All patients underwent surgery.PC in three cases was confirmed by routine histopathology and immunohistochemistry.CONCLUSION As clinical signs and laboratory results are nonspecific,it is difficult to diagnose PC preoperatively,so imaging examinations are often needed.
文摘A 24-year-old female patient with parathyroid carcinoma,the rarest endocrine malignancy,had two pregnancies.In the first pregnancy,she had severe nausea and fatigue.Hypercalcemia and hyperparathyroidism were diagnosed in the postpartum period.Hyperemesis gravidarum masked a diagnosis of hypercalcemia.Neck ultrasound and Tc-99 m sestamibi found an enlarged lower right parathyroid gland.The gland was surgically removed,and an initial pathology report described atypical adenoma.Shortly afterward,she became pregnant again.During the second pregnancy,her calcium level was frequently controlled but was always in the normal range.Normocalcemia is explained by the specific physiology of pregnancy accompanied by hemodilution,hypoalbuminemia and maternal hypercalciuria(mediated by increased glomerular filtration).During lactation,calcium levels rose,and a newneck ultrasound showed a solitary mass in the area of prior surgery and an enlarged pretracheal lymph node.Fine needle aspiration of the solitary mass and node showed parathyroid carcinoma cells.The tumor mass was resected en bloc with the contiguous tissues and surrounding lymph nodes(pathology report; parathyroid carcinoma with metastases).Over the next five years,four consecutive surgeries were performed to remove malignant parathyroid tissue,lymph nodes and local metastases.Following the surgical procedures,no hypocalcemia was observed.More serious hypercalcemia recurred; the calcium level was difficult to control with a combination of pamidronate,cinacalcet and loop diuretic.No elements of multiple endocrine neoplasia were present.
基金Supported by FIS del Instituto de Salud Carlos Ⅲ(FEDER from E.U.),Spain,No.PI13/00322 and PI16/00884
文摘BACKGROUND Pituitary apoplexy represents one of the most serious,life threatening endocrine emergencies that requires immediate management.Gonadotropin-releasing hormone agonist(GnRHa)can induce pituitary apoplexy in those patients who have insidious pituitary adenoma coincidentally.CASE SUMMARY A 46-year-old woman,with a history of hypertension and menorrhagia was transferred to our hospital from a secondary care hospital after complaints of headache and vomiting,with loss of consciousness 5 min after an injection of GnRHa.The drug was prescribed by her gynecologist due to the presence of uterine myomas.The clinical neurological examination revealed right cranial nerve III palsy,ptosis and movement limitation of the right eye.Our first clinical consideration was a pituitary apoplexy.Blood hormonal analysis revealed mild hyperprolactinemia and high follicle stimulating hormone level;PTH and calcium was high with glomerular filtration rate mildly to moderately decrease.A computed tomography scan,revealed an enlarged pituitary gland(3.5 cm)impinging upon the optic chiasm with bone involvement of the sella.Following contrast media administration,the lesion showed homogeneous enhancement with high-density focus that suggests hemorrhagic infarction of the tumor.Transsphenoidal endoscopic surgery was perfomed and adenomatous tissue was removed.Immunohistochemistry was positive for luteinizing hormone(LH)and follicular-stimulating hormone(FSH).A solid hypoechoic nodule(14 mm x 13 mm x 16 mm)was found in the caudal portion of the right thyroid lobe after a parathyroid ultrasound.A genetic test of Multiple Endocrine Neoplasia type 1(MEN1)was negative.A right lower parathyroidectomy was performed and the pathologic study showed the presence of an encapsulated parathyroid carcinoma of 1.5 cm.A MEN type 4 genetic test was performed result was negative.CONCLUSION This case demonstrates an uncommon complication of GnRH agonist therapy in the setting of a pituitary macroadenoma and the casual finding of parathyroid carcinoma.It also highlights the importance of suspecting the presence of a multiple endocrine neoplasia syndrome and to carry out relevant genetic studies.
基金This research was funded by National Natural Science Foundation of China(Grant Number:81760142)the High-level Health Talents Project of Yunnan Provincial(Grant Number:H-2017036).
文摘Parathyroid carcinoma is an extremely rare malignant tumor,composed primarily of vacuolated principal cells,but may also be composed of eosinophils.The exact etiology and pathogenesis of parathyroid carcinoma is unknown,and head and neck radiation exposure,chronic stimulation from renal failure,and familial syndromes can lead to the development of parathyroid carcinoma.Most parathyroid carcinoma is difficult to distinguish from benign HPT and is often diagnosed only when there is a recurrence of hypercalcemia several years later,which can manifest as weight loss,extreme fatigue,anorexia,and muscle atrophy.At present,surgical resection remains the primary treatment.In this case,the patient underwent initial surgery for primary hyperparathyroidism and was subsequently diagnosed with parathyroid carcinoma.During the 8 years of follow-up,the patient underwent 7 surgeries in combination with radiation therapy,chemotherapy and targeted medications.Although the neck tumor was cured,the patient died of complications related to hypercalcemia.We will review the literature on the combination of surgery,radiotherapy,chemotherapy,and targeted drug therapy in order to improve the diagnosis and treatment of parathyroid carcinoma.
文摘Parathyroid carcinoma （PC） is a rare neoplasm that accounts for 0. 1%-5% of primary hyperparathyroidism cases. Hyperparathyroidism-induced hypercalcemic crisis （HHC） is sometimes due to a single PC.1 However,
基金Supported by a grant from the Science and Technology Plan Projects of Lanzhou(No.2013-3-38)
文摘Objective The aim of the study was to investigate the effect of parathyroid hormone(PTH) on the apoptosis of human medullary thyroid carcinoma(MTC) cells.Methods In vitro cultured medullary thyroid carcinoma cell lines were treated with parathyroid hormone and parathyroid hormone receptor-monoclonal antibody,and the apoptosis of cells was detected by flow cytometry.Results The cell morphology changed significantly after treatment based on the observation using the inverted phase-contrast microscope.Various concentrations of parathyroid hormone and parathyroid hormone receptor-monoclonal antibody effectively induced apoptosis in a time-and concentrationdependent manner.When the concentration of parathyroid hormone was 2.0 μmol/L and that of parathyroid hormone receptor-monoclonal antibody was 1.0 μmol/L,the apoptotic rate was 13.24% and 20.78%,respectively,representing a statistically significant difference from that of the control cells(P < 0.05).Conclusion PTH plays a role in inducing apoptosis of human MTC cells.
