Autoparathyroidectomy: A case report

McLatchie, Greg; Morris, E. W.; Forrester, Alex C.; Fogelman, Ignac

doi:10.1002/bjs.1800660810

Cited by 21 publications

(10 citation statements)

References 7 publications

(4 reference statements)

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“…1). Contrary to our expectation, however, there was no necrotic tissue that would indicate a recent infarction of the adenoma [8][9][10]. Histopathologically it was difficult to explain why the serum PTH had spontaneously decreased twice.…”

Section: Case Reportcontrasting

confidence: 81%

An Instructive Case Suggesting Cyclical Primary Hyperparathyroidism

et al. 2006

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Abstract. We report an instructive case of primary hyperparathyroidism in which cyclical secretion of PTH may have caused repeated hypercalcemic crises followed by temporary remission with a spontaneous drop in PTH. A 64-year-old man was admitted to our hospital twice with severe hypercalcemic crisis (corrected calcium (cCa) 15.0 mg/dl and 16.7 mg/dl) accompanied by an increase in intact PTH (220 pg/ml and 470 pg/ml). During both events, the serum PTH values spontaneously dropped followed by remission of the hypercalcemia. The tumor, detected at the left-upper side, showed neither vascularity on ultrasound examination nor washout delay on MIBI scintigraphy, suggesting that two parathyroid adenoma infarctions had occurred. Cervical exploration was undertaken. The histopathological examinations confirmed that the tumor was parathyroid adenoma. Contrary to our expectation, however, it did not reveal necrotic tissue that would indicate recent infarction. The findings in this case may be explained by cyclical secretion of PTH from a parathyroid adenoma. Although cyclical Cushing's syndrome is well known, to our knowledge this is the first documented case suggesting cyclical primary hyperparathyroidism.

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Section: Case Reportcontrasting

confidence: 81%

An Instructive Case Suggesting Cyclical Primary Hyperparathyroidism

et al. 2006

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“…Her anemia due to iron deficiency has also completely improved after oral ferrotherapy for 6 months. The spontaneous infarction of parathyroid adenoma rarely causes the biochemical remission, resulting in normocalcemia [3][4][5][6], which is also called as autoparathyroidectomy [6]. The hypocalcemia in the present case might be associated with the hungry bone state after the parathyroid infarction.…”

Section: Primary Hyperparathyroidismmentioning

confidence: 85%

Hypocalcemia due to Spontaneous Infarction of Parathyroid Adenoma and Osteomalacia in a Patient with Primary Hyperparathyroidism.

et al. 1998

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Abstract. A 49 year-old Japanese woman had subjected enlargement of a cervical tumor, and also suffered two bone fractures in 2 years. The cervical tumor had enlarged further in the month prior to admission, becoming warm and tender. Endocrinological examination revealed that the serum intact PTH concentration was remarkably high at 400 pg/mL despite the low serum calcium concentration, and that the serum vitamin Ds concentration was decreased. Bone roentgenograms revealed severe osteolytic changes compatible with osteitis fibrosa cystica and a pathologic fracture of the humerus. Under a diagnosis of primary hyperparathyroidism, parathyroidectomy was performed, followed by fixation surgery for the pathologic fracture. Histologically, the cervical tumor was a parathyroid chiefcell adenoma with massive necrosis, and the bone pathology by iliac bone biopsy revealed the existence of osteomalacia. She was treated with calcium, vitamins D and K2 and calcitonin after the surgery. This case is a rare condition manifesting hypocalcemia with catastrophic osteoporosis under the coexistence of spontaneous infarction of parathyroid adenoma with osteomalacia, suggesting that the clinical features of hyperparathyroidism are modified by both the autoparathyroidiectomy and the existence of osteomalacia due to vitamin D deficiency.

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“…Remissions in these cases were generally attributed to hemorrhage and/or infarct of the adenoma [18][19][20][21][22][23]. This phenomenon has been termed "autoparathyroidectomy" or "parathyroid apoplexia" because of similarities with pituitary apoplexia [24].…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Remission of Primary Hyperparathyroidism in a Patient with Neurofibromatosis Type 1: Case Report

MM¹

2012

J Clin Case Rep

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Neurofibromatosis type 1 (NF1) is an autosomal dominant multisystem disorder affecting approximately 1 in 3500 individuals. Patients with the disorder can develop carcinoid tumors, medullary thyroid carcinoma, pheochromocytoma and tumor of the hypothalamus. The association of NF1 with Primary Hyperparathyroidism (HPP) is very rare. We report a 56-year-old woman with NF1 who was referred to our service because of nephrolithiasis. Physical examination revealed the characteristic signs of NF1, and her laboratory calcium profile was compatible with HPP. The patient was referred for parathyroidectomy, but during the surgical work-up she underwent spontaneous remission of her HPP. This case is significant not only for the rarity of this presentation in NF1 patients, but also because of the spontaneous remission of HPP.

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Autoparathyroidectomy: A case report

Abstract: This report describes a patient with primary hyperparathyroidism who became spontaneously normocalcaemic preoperatively. This was due to infarction in a parathyroid adenoma. Plasma parathormone (PTH) levels were monitored pre- and postoperatively.

Cited by 21 publications

References 7 publications

An Instructive Case Suggesting Cyclical Primary Hyperparathyroidism

An Instructive Case Suggesting Cyclical Primary Hyperparathyroidism

Hypocalcemia due to Spontaneous Infarction of Parathyroid Adenoma and Osteomalacia in a Patient with Primary Hyperparathyroidism.

Spontaneous Remission of Primary Hyperparathyroidism in a Patient with Neurofibromatosis Type 1: Case Report

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