Her Aching Bones: Atypical Parathyroid Adenoma

Rodrigues, Filipe B; Bekerman, Catarina; Neves, Joana B.; Sousa, J; Vieira, Joana; Alves, António; Palha, Ana; Rocha, José; Ramalhinho, V

doi:10.1016/j.amjmed.2015.11.007

Cited by 2 publications

(3 citation statements)

References 11 publications

(10 reference statements)

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“…Several case reports and studies have stated that the patients with APT had mild-to-moderate serum calcium levels similar to our study [3,5,12,13,[15][16][17] [3]. However, PTH levels were higher in the APT group in a previous study from Cakir et al [12].…”

Section: Discussionsupporting

confidence: 87%

“…There was no difference in ALP levels between groups in a study [12]. Even so, a signi cant increase was observed in a few case reports [15,17]. Many immunohistochemical markers, including PTH, chromogranin-A, GATA-3, Ki-67 labeling index, para bromin, adenomatous polyposis coli (APC), protein gene product 9.5 (PGP9.5), P53, galectin-3, have been studied to diagnose APC in parathyroid neoplasms [4,7].…”

Section: Discussionmentioning

confidence: 84%

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Differences Between Atypical Parathyroid Tumors and Parathyroid Adenomas in Patients with Primary Hyperparathyroidism

Aydemir,

Ünsal,

Ateş

et al. 2023

Indian J Surg

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Atypical parathyroid tumor (APT) is a rare disease that can be challenging to distinguish from parathyroid adenoma. APT shows some laboratory and histopathological features with parathyroid cancer. This study attempts to compare clinical, laboratory, radiologic and histopathological characteristics in APT and parathyroid adenoma (PA). MethodsThis was a retrospective study was based on the database of eighty-two subjects who underwent surgery for primary hyperparathyroidism at a tertiary referral center between 2010 and 2021. Forty-one patients with APT matched by age and gender to controls with PA. Clinical, laboratory, radiologic and characteristics were obtained from the hospital database. ResultsForty-ve (54.8%) of primary hyperparathyroidism (PHPT) patients were symptomatic, 36 (90%) had nephrolithiasis, 6 (15%) had fracture and 3 (7.5%) had hypercalcaemic crisis. APT patients present with signi cantly inceased serum calcium, parathormone (PTH) and alkalen phosphatase levels (P < .001, all). No signi cant difference was observed in the results of bone mineral density (BMD), T-scores and Z-scores. The size of adenoma was signi cantly greater in APT group (24 (8.8-70) mm vs. 12 (3.8-32) mm, P = 0.005). During the follow-up, multiple metastases due to parathyroid cancer were detected in one patient. ConclusionOur study revealed that increased preoperative serum calcium, parathormone, alkalen phosphatase concentrations and parathyroid adenoma size on ultrasound may have predicted the atypical parathyroid tumor.Dual X-ray absorptiometry (DXA) (Hologic) was used to measure bone mineral density (BMD), T-score and Z-score of lumbar spine, femoral neck and total femur. Z-scores were used for participants younger than 50 years of age.Preoperative neck ultrasonography and dual-phase technetium-99m sestamibi were the preferred methods to localize parathyroid adenomas. None of our patients underwent diagnostic ne-needle aspiration biopsy before the operation.The histology excluded certain malignancy features like the presence of vascular, lymphatic, perineural invasion and/or local/distant metastasis. The histological criteria for identifying an atypical parathyroid tumor was included the trabecular growth pattern, atypical mitotic gures, brous band formations.The immunohistochemically staining was employed using GATA-3, chromogranin A and P53.This study was approved by the ethics committee of the Local Ethics Board (app. no.: 2021-19/13). Statistical AnalysisAccording to the normality tests, medical records of patients were expressed as mean and standard deviation (SD), median and range. Categorical variables were summarized with count and percentage. Pearson's chi-square was performed for comparisons of categorical variables. Continuous variables were compared using an independent samples t-test or Mann-Whitney test. The normality of data was explored by the Shapiro-Wilk test. Statistical analysis was performed using SPSS 23.0 software package. P-values less than 0.05 were considered statistically signi cant. ResultsEig...

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 84%

Differences Between Atypical Parathyroid Tumors and Parathyroid Adenomas in Patients with Primary Hyperparathyroidism

Aydemir,

Ünsal,

Ateş

et al. 2023

Indian J Surg

View full text Add to dashboard Cite

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“…This is of relevance in parathyroid tumors classification, because atypical adenomas diagnosis is challenging, and they are currently distinguished from carcinomas mainly on the absence of invasive growth and metastasis. ( 32 ) Our data also show that despite the heterogeneity of PAds in expression of lncRNAs, part of this heterogeneity is explained by gross chromosomal aberrations, such as chromosome 1, 11, 15, 21, or 22 losses. Indeed, HAR1B is overexpressed in PAds with chromosome 11 or 21 LOH, whereas HOXA6as , NEAT1 , and SNHG6 are underexpressed in parathyroid tumors with chromosomal aberrations.…”

Section: Discussionsupporting

confidence: 66%

The Oncosuppressors MEN1 and CDC73 Are Involved in lncRNA Deregulation in Human Parathyroid Tumors

Morotti

Forno

Verdelli

et al. 2020

Journal of Bone and Mineral Research

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A role for long non‐coding RNAs (lncRNAs) in endocrine cancer pathogenesis is emerging. However, knowledge regarding their expression pattern, correlation with known genetic defects, and clinical implications in parathyroid tumors is still unclear. Here, we profiled 90 known lncRNAs in a first series of normal (PaN = 2), adenomatous (PAd = 12), and carcinomatous (PCa = 4) parathyroid glands and we confirmed deregulation of 11 lncRNAs using an independent cohort of patients (PaN = 4; PAd = 26; PCa = 9). Expression of lncRNAs was correlated with cytogenetic aberrations, status of genes multiple endocrine neoplasia 1 (MEN1) and cell division cycle 73 (CDC73), or clinical features. Globally, lncRNAs discriminate according to tissue histology. BC200 consistently identifies parathyroid cancers from adenomas and atypical adenomas. Loss‐of‐heterozygosity (LOH) at chromosomes 1, 11, 15, 21, and 22 significantly impacts expression of lncRNAs in PAds. Silencing of the key parathyroid gene MEN1 modulates the expression of six lncRNAs in primary PAds‐derived cultures. Analogous levels of lncRNAs are measured in PAds with the mutation in the MEN1 gene compared with PAds with wild‐type MEN1. Similarly, carcinomas with mutated CDC73 differ from PCas with wild‐type protein in terms of expression of lncRNAs. PCas harboring CDC73 mutations overexpress BC200 compared to wild‐type carcinomas. Overall, these findings shed light on deregulation of lncRNAs in human parathyroid tumors and propose that circuits between lncRNAs and the oncosuppressors MEN1 or CDC73 may have a role in parathyroid tumorigenesis as epigenetic modulators. © 2020 American Society for Bone and Mineral Research (ASBMR).

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Her Aching Bones: Atypical Parathyroid Adenoma

Cited by 2 publications

References 11 publications

Differences Between Atypical Parathyroid Tumors and Parathyroid Adenomas in Patients with Primary Hyperparathyroidism

Differences Between Atypical Parathyroid Tumors and Parathyroid Adenomas in Patients with Primary Hyperparathyroidism

The Oncosuppressors MEN1 and CDC73 Are Involved in lncRNA Deregulation in Human Parathyroid Tumors

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