Massive 4-Gland Parathyroid Hyperplasia Initially Detected as a Parathyroid Adenoma.

Autor: Nicolich-Henkin S; Division of Endocrinology, NYU Long Island School of Medicine, Mineola, NY 11501, USA., Goldstein MB; Division of Endocrinology, NYU Long Island School of Medicine, Mineola, NY 11501, USA., Roellke E; Department of Medicine, NYU Long Island School of Medicine, Mineola, NY 11501, USA., Bilezikian JP; Department of Medicine, Division of Endocrinology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA., Rothberger GD; Division of Endocrinology, NYU Long Island School of Medicine, Mineola, NY 11501, USA.
Jazyk: angličtina
Zdroj: JCEM case reports [JCEM Case Rep] 2024 Jan 05; Vol. 2 (1), pp. luad173. Date of Electronic Publication: 2024 Jan 05 (Print Publication: 2024).
DOI: 10.1210/jcemcr/luad173
Abstrakt: Parathyroid adenoma (PA) and parathyroid hyperplasia (PH) are common causes of primary hyperparathyroidism (PHPT), for which the only definitive treatment is surgery. Abnormalities in the parathyroid glands can be identified with various imaging modalities including ultrasound (US), sestamibi scan (MIBI), 4-dimensional computed tomography (4D-CT), and positron emission tomography/computed tomography (PET/CT). While it is not uncommon for parathyroid pathology to be undetected on imaging, this is more typical of low-volume hyperplasia and smaller-sized adenomas. We present the case of a 65-year-old man with PHPT who initially had a solitary parathyroid mass detected by US, but who was ultimately discovered to have massive PH with hyperplastic glands not visualized on US or MIBI. This atypical presentation may help guide providers in decisions on ordering and interpreting various imaging modalities for patients with PHPT. In this case, 4D-CT was the only modality in which large hyperplastic glands were identified, suggesting superior sensitivity. This case also highlights the importance of intraoperative parathyroid hormone testing to aid in diagnostic prediction.
(© The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society.)
Databáze: MEDLINE
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