• Title/Summary/Keyword: Parathyroid gland

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The Parathyroid Gland: An Overall Review of the Hidden Organ for Radiologists (부갑상선: 부갑상선 영상에 익숙하지 않은 영상의학과 의사들을 위한 전반적인 검토)

  • Suho Kim;Jung Hee Shin;Soo Yeon Hahn;Haejung Kim;Myoung Kyoung Kim
    • Journal of the Korean Society of Radiology
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    • v.85 no.2
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    • pp.327-344
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    • 2024
  • Parathyroid glands are small endocrine glands that regulate calcium metabolism by producing parathyroid hormone (PTH). These are located at the back of the thyroid gland. Typically, four glands comprise the parathyroid glands, although their numbers may vary among individuals. Parathyroid diseases are related to parathyroid gland dysfunction and can be caused by problems with the parathyroid gland itself or abnormal serum calcium levels arising from renal disease. In recent years, as comprehensive health checkups have become more common, abnormal serum calcium levels are often found incidentally in blood tests, after which several additional tests, including a PTH test, ultrasonography (US), technetium-99m sestamibi parathyroid scan, single-photon-emission CT (SPECT)/CT, four-dimensional CT (4D-CT), and PET/CT, are performed for further evaluation. However, the parathyroid gland remains an organ less familiar to radiologists. Therefore, the normal anatomy, pathophysiology, imaging, and clinical findings of the parathyroid gland and its associated diseases are discussed here.

Treatment Experiences of Parathyroid Gland Tumors in 6 Cases (부갑상선 종양의 치험 6례)

  • Cho, Woo-Sung;Kim, Woo-Joo;Yoo, Ik-One;Hwang, Ho-Yeon;Baek, Seung-Kuk;Woo, Jeong-Soo;Kwon, Soon-Young;Jung, Kwang-Yoon
    • Korean Journal of Head & Neck Oncology
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    • v.23 no.2
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    • pp.165-169
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    • 2007
  • Parathyroid gland tumor is an uncommon disease. The symptoms of parathyroid gland tumor appear in various features such as general weakness, renal stones, bone diseases and malignancies in some cases. We summarized the clinical features of 6 cases of parathyroid gland tumors with literatures.

A Case of Ectopic Parathyroid Gland in the Hypopharyngeal Wall (하인두벽에 발생한 이소성 부갑상선 1예)

  • Jung, Jae Yeup;Park, Kye Hoon;Jang, Si-Hyong;Ban, Myung Jin
    • Korean Journal of Head & Neck Oncology
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    • v.34 no.1
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    • pp.29-32
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    • 2018
  • The parathyroid glands are usually located in the posterolateral area of the thyroid gland. Due to their embryologic origin, they are sometimes found in an ectopic position from the angle of the jaw to the mediastinum. However, their incidental detection in the hypopharyngeal wall is rare. Herein, we report a case of an ectopic parathyroid gland found in the hypopharyngeal wall of a 39-year old woman with no known endocrine abnormality.

Hyperplastic Autotransplanted Parathyroid Tissue Migrating into Fatty Tumor after Total Parathyroidectomy

  • Reza, Joseph Arturo;Wiese, Georg Kristof;Portoghese, Joseph Dominic
    • Journal of Endocrine Surgery
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    • v.18 no.4
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    • pp.236-239
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    • 2018
  • Secondary hyperparathyroidism (SHPTH) occurs commonly in patients with end-stage renal disease (ESRD). Uncontrolled SHPTH is associated with complications of calcium deposition including calciphylaxis and elevated rates of cardiovascular morbidity. Current treatment recommendations for medically refractory disease include total parathyroidectomy, often with autotransplantation (TPTH+AT) of minced parathyroid gland. Surgical intervention is associated with a reduction in cardiovascular mortality. We report a case of a 56-year-old man with ESRD who developed SHPTH and underwent TPTH+AT of parathyroid tissue into the right brachioradialis muscle. Over the course of 7 years he developed a mass at the site of the autotransplanted gland as well as recurrent refractory hyperparathyroidism with increased forearm uptake noted on sestamibi scan. After excision of this mass, pathology demonstrated hyperplasia of the minced gland fragments which were embedded within a mass of fibroadipose tissue rather than the muscle tissue it was originally transplanted in.

A Case of Functionary Cystic Parathyroid Adenoma with Papillary Thyroid Carcinoma (유두상 갑상선암과 동반된 기능성 낭종성 부갑상선 선종 1예)

  • Chang, Woo-Jin;Jung, Hyun-Hee;Park, Sang-Hyen;Sohn, Se-Hoon;Yoon, Ji-Sung;Lee, Hyoung-Woo;Won, Kyu-Chang;Cho, In-Ho
    • Journal of Yeungnam Medical Science
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    • v.27 no.2
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    • pp.139-145
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    • 2010
  • Cystic parathyroid adenoma is one of rare causes of hyperparathyroidism, and tends to cause increased serum level of parathyroid hormone, alkaline phosphate and serum calcium level similar to when compared to those of solid adenoma. The possibility of a coincidental appearance of primary hyperparathyrodism and nonmedullary thyroid cancer is rare, and often neglected. A 40-year-old female presented with constipation and weight loss for 3 months. The serum calcium, phosphate and alkaline phosphate were 16.6 mg/dl, 2.2 mg/dl and 505 IU/L respectively and serum parathyroid hormone level was 1556.2 pg/mL. Neck US showed mixed nodules at both thyroid lobes, and PET-CT showed a right thyroid nodule without FDG uptake. The patient was diagnosed of primary hyperparathyroidism and underwent parathyroidectomy and a total thyroidectomy. Histopathologic results revealed parathyroid adenoma with cystic change (2 cm greater diameter) in the right lower parathyroid gland and coexistent papillary carcinoma of the right lobe of thyroid gland (infiltrating, 0.3 cm in greater diameter). She remained well and serum calcium, phosphate, parathyroid hormone level were normalized within 24 hours.

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Clinical Study of Primary Hyperparathyroidism (원발성 부갑상선 기능항진증에 대한 임상적 고찰)

  • Jung Kwang-Yoon;Lee Jong-Soo;Choi Jong-Ouck;Baik Sei-Hyun
    • Korean Journal of Head & Neck Oncology
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    • v.10 no.1
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    • pp.31-37
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    • 1994
  • Primary hyperparathyroidism is rare disease entity which secretes parathyroid hormone in excessively resulting in hypercalcemia. It involves skeletal system, urinary tract, gastrointestinal tract, and central nervous system. Recently the determination of the serum calcium and parathyroid hormone level has become a routine laboratory test and the localization of involved gland by neck ultrasonogram and parathyroid gland substraction scan has reduced operative complications. For the purpose of improvement of diagnosis and treatment, the authors analyzed the clinical characteristics of 6 cases of primary hyperparathyroidism(adenoma 5 cases, carcinoma 1 case) during 10 years and report with literatures.

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Tc-99m MIBI and Tl-201 Uptake in a Thymic Carcinoma (악성 흉선종에서 관찰된 Tc-99m MIBI와 Tl-201의 섭취)

  • Hyun, In-Young
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.4
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    • pp.260-261
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    • 2003
  • 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.

Primary Hyperparathyroidism due to Parathyroid Adenoma (부갑상선 선종에 의한 원발성 부갑상선 기능 항진증)

  • Park, Woo-Hyun;Bae, Byung-Jin;Choi, Soon-Ok
    • Advances in pediatric surgery
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    • v.6 no.1
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    • pp.68-69
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    • 2000
  • A case of primary hyperparathyroidism due to parathyroid adenoma is presented. A 14 year-old male was admitted to the hospital comptaining of voiding difficulty. The intravenous pyelogram demonstrated a stone in the proximal one third of the left ureter and marked hydronephrosis of the left kidney. The Tc-99m sestamibi nuclear scan demonstrated a hot spot below the lower pole of the left lobe of the thyroid. Laboratory study demonstrated hypercalcemia (12.4 mg/dL) and elevated parathyroid hormone (143.67 pg/mL). A parathyroid gland located below the lower pole of the left lobe of the thyroid was excised. A parathyroid adenoma, consisting of mainly chief cells was found on pathologic examination. Postoperatively the patient had transient hypocalcemic symptoms, which resolved with administration of calcium preparation and vitamin D.

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Regulation of Calcium Concentration in Primary and Secondary Hyperparathyroidism

  • Kim, Yong-baek
    • Proceedings of the Korean Society of Veterinary Pathology Conference
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    • 2003.10a
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    • pp.35-38
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    • 2003
  • The parathyroid gland is probably the simplest endocrine organ in the body. The only cells of clinical significance are the parathyroid or chief cells. The primary signal that these cells listen to is calcium. Primary hyperparathyroidism is due to a parathyroid adenoma. The most common cause of hypercalcemia in veterinary medicine is hypercalcemia of malignancy associated with variety of neoplasms. Secondary hyperparathyroidism is due to a disease process, most commonly associated with renal and nutritional hyperparathyroidism. Primary and secondary hyperparathyroidism are markedly different in their clinical, laboratory, and pathogenic mechanism.

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Minimally Invasive Parathyroidectomy using Intraoperative Ultrasonography in Parathyroid Adenoma Patients with a History of Total Thyroidectomy (갑상선 전절제술 과거력이 있는 부갑상선 선종 환자에서 수술 중 초음파 검사를 이용한 최소침습 부갑상선 절제술 1예)

  • Yunbin Nam;Hyun Taek Jung;Sang Mok Lee;Ji-Hoon Kim
    • Korean Journal of Head & Neck Oncology
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    • v.39 no.2
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    • pp.27-30
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    • 2023
  • A 65-year-old patient who underwent total thyroidectomy 10 years ago was suspected of having a parathyroid adenoma, and minimally invasive parathyroidectomy was planned. Preoperative ultrasonography(USG) and 99mTc MIBI scan indicated a left lower parathyroid lesion. In the first operation, intraoperative parathyroid hormone monitoring (IOPTH) was not possible due to hospital circumstances. Although no adenomatous lesion was found in the expected surgical field, surgery was completed after removing lesions around the left lower parathyroid gland. However, post-surgery, parathyroid hormone did not decrease at all, so a second operation was performed with IOPTH preparation. In the second operation, intraoperative ultrasonography was performed, and a suspected adenoma lesion was removed from the left upper lesion. He has been under follow-up for 3 years without complications. Surgeon-peformed intraoperative USG and preoperative scintigraphy had advantages in determining the localization of parathyroid lesion even withiout IOPTH.