Parathyroid carcinoma: a review with three illustrative cases.

1. Department of Head and Neck Surgery, Free University of Brussels. Jules Bordet institute, 1000 Brussels, Belgium.
Journal of Cancer 01/2011; 2:532-7.
Source: PubMed

ABSTRACT Parathyroid carcinoma is a rare disease, which accounts for less than 1% of all case of primary hyperparathyroidism and is usually not detected until the time of surgery or thereafter. For most patients preoperative staging is not available. A radical excision remains the standard management; the place of adjuvant radiotherapy is not well established yet. Local recurrence and/or the metastases are unfortunately frequent. The present paper presents an up to date review of the literature illustrated by three clinical cases.

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    ABSTRACT: Today, primary hyperparathyroidism (PHPT) is frequently diagnosed at an asymptomatic stage. New international guidelines presented at the Endocrine Society congress update the management of this disease. Normocalcemic PHPT is part of the diagnostic spectrum of PHPT, its natural history is poorly known, and monitoring is proposed once secondary HPT has been eliminated. Bone involvement, classically predominant in cortical bone, also affects trabecular bone. Osteodensitometry is poorly effective at the vertebral level and new methods (trabecular bone score [TBS], vertebral fracture assessment [VFA]) should improve the assessment of the risk of fracture. The kidney is the most frequently symptomatic organ, and an imaging workup as well as urinary tests are recommended in all patients when searching for causes of lithiasis or nephrocalcinosis. More than 10% of PHPT cases are related to a germinal mutation: these patients should be identified to optimize their management and that of their relatives. Medical treatment is reserved for patients for whom surgery is not indicated or possible: cinacalcet is effective for calcemia, the bisphosphonates are effective for bone involvement. Vitamin D deficiency can be corrected as long as calcemia and creatinuria are monitored. Surgical treatment is recommended in case of pronounced hypercalcemia, bone or renal involvement, and age less than 50 years and in patients in whom monitoring is refused or impossible. Studies have shown that asymptomatic PHPT evolves little in monitored patients. Copyright © 2014 Elsevier Masson SAS. All rights reserved.
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    ABSTRACT: Parathyroid carcinoma is a very rare malignancy. It has been associated with hyperparathyroidism-jaw tumour syndrome, familial isolated primary hyperparathyroidism, and multiple endocrine neoplasia type 1 (MEN-1) and 2A (MEN-2A) syndromes. We report a 54-year-old man with a MEN-2A which presents with a nonfunctional metastatic parathyroid carcinoma and a pheochromocytoma in the absence of medullary thyroid carcinoma. Only a few cases of parathyroid carcinoma have been reported in the literature associated with this syndrome.
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    ABSTRACT: The main aim of this investigation is the clinical application of ultrasound irradiation technique as an alternative method to reconstitute sestamibi kits in comparison of water boiling bath method. The 740-3700 MBq (20-100 mCi) (99m)Tc-MIBI (sestamibi) complex samples were prepared due to ultrasound irradiation technique or boiled water bath method as a standard method. Twenty patients (8 men and 12 women; age range 30-72, median 52.45 years) have been referred to Golestan hospital for myocardial perfusion imaging (MPI). The subjects have been divided randomly into group A (3 men, 7 women, age range 36-67, median 51.7 years) and group B (5 men, 5 women, age range 30-72, median 50.3 years), respectively. The (99m)Tc-MIBI radiopharmaceuticals have been prepared by Ultrasound irradiation technique administrated to group A and (99m)Tc-MIBI complex samples due to the boiled water bath technique administrated to the other group. For all patients, the 2-day stress/rest MPI protocol was performed. The radio-HPLC and TLC studies have indicated that the (99m)Tc-MIBI complex samples with good yields could be prepared successfully due to new developed technique. The scintigraphy imaging studies have demonstrated that the (99m)Tc-sestamibi prepared due to the above-mentioned modalities shows very identical biodistribution in the heart, thyroid, lung, liver, gallbladder, kidneys, stomach, large intestine and bladder of the subjects. Any unexpected accumulation of radiotracer samples have not been observed in our approach. The ultrasound irradiation technique is convenient and sufficient method to prepare (99m)Tc-sestamibi. It can be recommended as an alternative method to reconstitute sestamibi kits particularly in emergency situations to reduce potentially medical risk by avoiding any delay in acute therapy for myocardial infarction.
    Annals of Nuclear Medicine 12/2014; DOI:10.1007/s12149-014-0941-7 · 1.41 Impact Factor

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