• 제목/요약/키워드: Primary hyperparathyroidism

검색결과 38건 처리시간 0.027초

상하악에 발생한 갈색종의 증례보고 (A CASE REPORT ; BROWN TUMOR OF THE MAXILLA AND MANDIBLE IN ASSOCIATION WITH PRIMARY HYPERPARATHYROIDISM)

  • 이주경;조성대;임대호
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제31권1호
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    • pp.61-66
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    • 2009
  • The brown tumors develop in bone and it develop on various area which in clavicle, rib bone, cervical bone, iliac bone etc. The development on the maxillofacial region is rare, relatively more develop on the mandible. The brown tumor directly develop by the dysfunction of calcium metabolism according to hyperparathyroidism and differential diagnosis with other bone lesion should be difficult if it would diagnose by only radiographic features. The histological feature is that proliferation of spindle cells with extravasated blood and haphazardly arranged, variably sized, multinucleated giant cell is seen. The brown tumor is firm diagnosed by physical examination, because of these histological feature show similar with other giant cell lesions(giant cell granuloma, aneurysmal bone cyst, cherubism). The brown tumors have been described as resulting from an imbalance of osteoclastic and osteoblastic activity. It result in bone resorption and fibrous replacement of the bone. So these lesions represent the terminal stage of hyperparathyroidism-dependent bone pathology. Therefore, it is the extremely rare finding that brown tumor in the facial bone as the first manifestation of an hyperparathyroidism. We experience 1 case of brown tumor(50 years old female) that developed on Maxilla and mandible with no history of hyperparathyroidism. So we report this case with a literature review.

원발성 부갑상선 기능 항진증의 수술전 병소확인에서 $^{99m}Tc$-Sestamibi 스캔의 유용성 (The Usefulness of $^{99m}Tc$-Sestamibi Scan in Preoperative Localization in Primary Hyperparathyroidism)

  • 백세현;김수미;최경묵;최윤상;김상진;유재명;최동섭;최재걸
    • 대한핵의학회지
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    • 제29권4호
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    • pp.465-472
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    • 1995
  • 목적 : 원발성 부갑상선기능 항진증의 대부분의 원인인 부갑상선 선종의 유일한 완치는 수술이며 수술의 성패에 가장 중요한 것은 수술전의 정확한 ??소의 확인이다. 다양한 영상검사들이 동원되고있으나 각가 결점이 있고 가장 특이도가 높은 $^{201}T1-^{99m}Tc$감영 촬영방법도 검사방법등에 문제점이 있다. 이에 원발성 부갑상선기능 항진증 환자에게 최근에 사용되고있는 $^{99m}Tc$-Sestamibi 부갑상선 스캔의 유용성을 알아보고자 하였다. 대상 및 방법 : 19명의 부갑상선기능 항진증환자에서 모든 환자에게 초음파 검사, CT, $^{201}T1-^{99m}Tc$감영 촬영을 시행하고 그중 5명은 $^{99m}Tc$-Sestamibi 부갑상선 스캔을 시행하여 수술후 확진결과와 함께 비교하였다. 결과 : 초음파 검사와 CT 및 $^{201}T1-^{99m}Tc$감영 스캔은 19예중 각가 12예(67.1%), 14예(78.9%) 그리고 17예(89.5%)에서 병소확인이 가능하였고 $^{99m}Tc$-Sestamibi 부갑상선 스캔은 시행한 5예(100%) 모두에서 병소 확인이 가능하였다. 결론 : 이상의 결과로 $^{99m}Tc$-Sestamibi 부갑상선 스캔은 원발성 부갑상선기능 항진증의 수술전 병소확인에서 유용한 검사법으로 이용될 수 있으리라 사료된다.

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초음파 유도 에탄올 주입법을 이용한 개의 원발성 부갑상선항진증 치료 (Percutaneous Ultrasound Guided Ethanol Ablation of Primary Hyperparathyroidism in a Dog)

  • 최지혜;김진경;김현욱;김학상;김준영;윤정희
    • 한국임상수의학회지
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    • 제24권3호
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    • pp.457-460
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    • 2007
  • Primary hyperparathyroidism (PHP) is rare in dogs. Mainly functional solitary parathyroid adenoma causes hypercalcemia due to excessive autonomous secretion of parathyroid hormone (PTH). PHP can be diagnosed based on serum calcium phosphorus, ionized calcium and PTH, and cervical ultrasound provides important information about the number size and location of parathyroidal lesion. Ultrasound guided intralesional ethanol injection has been used as an alternative to surgical treatment of PHP. In this case, PHP was diagnosed in 12 year-old Pug with clinicopathologic examination and cervical ultrasound, and the parathyroidal mass was ablated successfully through ultrasound guided ethanol injection.

Recurrent thymic carcinoid tumor in familial isolated primary hyperparathyroidism

  • Song, Jeong Eun;Shon, Mu Hyun;Kim, Ga Young;Lee, Da Young;Lee, Jung Hun;Kim, Jong Ho;Shon, Ho Sang;Lee, Ji Hyun;Jeon, Eon Ju;Jung, Eui Dal
    • Journal of Yeungnam Medical Science
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    • 제31권2호
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    • pp.131-134
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    • 2014
  • Familial isolated primary hyperparathyroidism(FIPH) is associated with multiple endocrine neoplasia type 1 (MEN1) syndrome, primary hyperparathyroidism accompanied by jaw-tumor syndrome, and familial hypocalciuric hypercalcemia. FIPH may be an early stage of MEN1 or an allelic variant of MEN1. Thymic carcinoid tumor is a rare tumor in MEN1 syndrome. Here, the authors report the case of a 40-year-old man diagnosed with recurrent thymic carcinoid tumor and FIPH. Both the patient and his elder sister had been previously diagnosed to have FIPH with a novel frameshift mutation in the MEN1 gene. Initially, the patient underwent thymectomy because of an incidental finding of a mediastinal mass in his chest X-ray, and had remained asymptomatic over the following 4 years. Pancreas computed tomography conducted to evaluate MEN1 syndrome revealed anterior and middle mediastinal masses, and resultantly, massive mass excision was performed. Histological findings disclosed atypical carcinoids with infiltrative margins. In view of the thymic carcinoid tumor relapse that occurred in this patient, the authors recommend that regular pancreas and pituitary imaging studies be conducted for FIPH associated with a MEN1 gene mutation.

원발성 부갑상선항진증에 의한 악골의 다발성 갈색종양 (Multiple brown tumors of the jaws in primary hyperparathyroidism)

  • 김경아;고광준
    • Imaging Science in Dentistry
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    • 제40권3호
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    • pp.149-153
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    • 2010
  • Brown tumor is usually diagnosed at the terminal stage of hyperparathyroidism. Diagnosis of this tumor is confirmed by endocrinologic investigations along with clinical and radiographic examination. Radiographical differential diagnosis of this tumor includes central giant cell granuloma, aneurysmal bone cyst, metastatic tumor, multiple myeloma, and Paget disease. This report presents a rare case of multiple brown tumors occurring at the maxilla and mandible, which was initially misdiagnosed as central giant cell granuloma. Plain radiographs demonstrated multiple well-defined multilocular radiolucency. CT images showed soft tissue mass with low attenuated lesions, perforation of the lingual cortical plate, and a heterogeneous mass at the right thyroid lobe. These findings were consistent with parathyroid adenoma. The patient had hypercalcemia, hypophosphatemia, and elevated alkaline phosphatase level. Surgical excision of the tumor was performed. No recurrence was observed during a 28-month follow-up.

Clinical Study on Safety and Efficacy of Microwave Ablation for Primary Hyperparathyroidism

  • Ying Wei;Lili Peng;Yan Li;Zhen-long Zhao;Ming-an Yu
    • Korean Journal of Radiology
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    • 제21권5호
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    • pp.572-581
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    • 2020
  • Objective: To evaluate the safety, feasibility, and efficacy of microwave ablation (MWA) for the treatment of primary hyperparathyroidism (PHPT). Materials and Methods: This study enrolled 67 PHPT patients (22 men, 45 women; mean age, 56.0 ± 16.3 years; range, 18-83 years) from January 2015 to December 2018. The laboratory data, including the serum intact parathyroid hormone (iPTH), calcium, phosphorus, and alkaline phosphatase (ALP) levels, were evaluated before MWA and again 2 hours, 1 day, 7 days, 1 month, 3 months, 6 months, 12 months, 18 months, and 24 months after. Results: Complete ablation was achieved with all 72 hyperplastic parathyroid glands found on the 67 patients enrolled, 64 of whom were treated in one session and 3 were treated over two sessions. The technical success rate was 100%. The median follow-up time was 13.6 months (range, 10.0-31.1 months). The clinical success rate was 89.4%. The volume reduction rate was 79.4% at 6 months. Compared to pre-MWA, the serum iPTH, calcium, phosphorus, and ALP levels had significantly improved 6 months post-MWA (iPTH, 157.3 pg/mL vs. 39.2 pg/mL; calcium, 2.75 ± 0.25 mmol/L vs. 2.34 ± 0.15 mmol/L; phosphorus, 0.86 ± 0.20 mmol/L vs. 1.12 ± 0.22 mmol/L; ALP, 79 U/L vs. 54 U/L, respectively; all, p < 0.01). Hoarseness was a major complication in 4 patients (6.0%), but it improved spontaneously within 2-3 months. Conclusion: MWA is safe, feasible, and effective for the treatment of PHPT.

Significance of HCG to Distinguish Parathyroid Carcinoma from Benign Disease and in Adding Prognostic Information: A Hospital Based Study from Nepal

  • Gupta, Satrudhan Pd.;Mittal, Ankush;Sathian, Brijesh
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권1호
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    • pp.325-327
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    • 2013
  • Objective: To differentiate between benign and malignant hyperparathyroidism on the basis of excretion of HCG and its malignant isoforms in urine. Materials and Methods: This hospital based study was carried out using data retrieved from the register maintained in Manipal Teaching Hospital from $1^{st}$ January, 2008 and $31^{st}$ August, 2012. The variables collected were urinary HCG and HCG malignant isoform, calcium and parathyroid hormone. Preceding the study, approval was obtained from the institutional research ethical committee. Analysis was by descriptive statistics and testing of hypothesis. A p-value of <0.05 (two-tailed) was used to establish statistical significance. Results: Out of the 20 cases, 10 were primary hyperparathyroidism and the remainder were parathyroid carcinomas. The urinary HCG $6.1{\pm}0.6$ fmol/mgCr was with in normal range in benign hyperthyroidism but was markedly elevated in three cases of malignant hyperparathyroidism (maximum value of excretion in urine for HCG was 2323 fmol/mgCr). The excretion of malignant isoform of HCG in urine was 0 in benign hyperparathyroidsm and in four cases of malignant hyperparathyroidism which fell into the category of persistantly low HCG. The maximum excretion of the malignant isoform of HCG in urine was 1.8, in the category of very high HCG. Calcium and parathyroid hormone were mildly raised in benign parathyroidism, while parathyroid hormone was markedly elevated in cases of malignant hyperparathyroidism falling into the category of very high HCG. Conclusions: The excretion of urinary HCG in urine has the ability to distinguish between parathyroid adenomas and carcinomas and thus has potential to become a marker of disease progression in malignant parathyroid disease.

이차성 부갑상선 기능항진증과 동반된 갑상선내 부갑상선암 1예 (A Case of Intrathyroidal Parathyroid Carcinoma Associated with Secondary Hyperparathyroidism)

  • 권민수;장항석;김호근;정웅윤;임승길;박정수
    • 대한두경부종양학회지
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    • 제15권2호
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    • pp.235-238
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    • 1999
  • Parathyroid carcinoma is rare, occurring in less than 2-3% of the patients with primary hyperparathyroidism. In the patients with chronic renal failure, the incidence is extremely low. Only 13 cases of parathyroid carcinoma with chronic renal failure have been described in the world literature. We report a case of parathyroid carcinoma in a 43-year-old man who has been suffered from chronic renal failure for 19 years. To our knowledge, this is the first case of parathyroid carcinoma occurring in the thyroid gland associated with secondary hyperparathyroidism.

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

  • 장우진;정현희;박상현;손세훈;윤지성;이형우;원규장;조인호
    • Journal of Yeungnam Medical Science
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    • 제27권2호
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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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