Malignant neoplasms and parathyroid adenoma

Kaplan, Leo; Katz, Alfred D.; Ben-Isaac, Clara; Massry, Shaul G.

doi:10.1002/1097-0142(197108)28:2<401::aid-cncr2820280221>3.0.co;2-h

Cited by 96 publications

(13 citation statements)

References 40 publications

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“…The other group, most of whom did not have demonstrable bone metastasis, had UcAMP levels similar to patients with 1°HPT except that several had levels higher than any encountered in the hyperparathyroid group. This suggests that the mechanism for the hypercalcemia in this group was the ectopic production of biologically active PTH, although the presence of an accompanying parathyroid adenoma in the nonautopsied cases cannot be entirely excluded (16). Serum iPTH in four patients in this group revealed levels that were inappropriately high when compared to normal subjects but were inappropriately low when compared to patients with 1°HPT with similar degrees of hypercalcemia.…”

Section: Resultsmentioning

confidence: 99%

Urinary cyclic AMP analyzed as a function of the serum calcium and parathyroid hormone in the idfferential diagnosis of hypercalcemia.

Shaw¹,

Oldham²,

Rosoff³

et al. 1977

J. Clin. Invest.

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A B S T R A C T Urinary cyclic AMP (UcAMP) appropriate for the serum calcium concentration was determined in normal subjects during the base-line state and during alteration in their serum calcium concentrations by saline and calcitum infusions. This was compared to the UcAMP in 76 patients with hypercalcemia and 5 patients with hypocalcemia. In 54 of 56 patients with primary hyperparathyroidism, the UcAMP was inappropriately high for their serum calcium concentration, the 2 exceptions having renal failure. In four patients with vitamin D intoxication, sarcoidosis, milkalkali syndrome, and thiazide-induced hypercalcemia and in five patients with hypocalcemia due to hypoparathyroidism, the UcAMP was appropriately low for their serum calcium concentration. In 16 patients with nonparathyroid neoplasms, 10 had UcAMP levels that were inappropriately high suggesting ectopic parathyroid hormone (PTH)-mediated hypercalcemia and 6 had UcAMP levels that were appropriately low suggesting that their hypercalcemia was due to osteolytic factors other than PTH. Correlations between UcAMP, senrm calcium concentration, and carboxyl-terminal immtunoreactive PTH suggest that random UcAMP is a sensitive accurate reflection of circulating biologically active PTH.If there is adequate renal function (serum creatinine concentration less than 2.0 mg/dl), a random UcAMP expressed as ,umol/g creatinine and analyzed as a function of the serum calcium concentration completely separates patients with PTH and non-PTHmediated hypercalcemia.

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Section: Resultsmentioning

confidence: 99%

Urinary cyclic AMP analyzed as a function of the serum calcium and parathyroid hormone in the idfferential diagnosis of hypercalcemia.

Shaw¹,

Oldham²,

Rosoff³

et al. 1977

J. Clin. Invest.

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“…The increased relative risk of breast and renal carcinomas is difficult to explain by any bias, although only sporadic cases with an association with hyperparathyroidism have been reported (2,(8)(9)(10).…”

Section: Relative Risk By Observation Timementioning

confidence: 99%

Increased Risk of Malignant Diseases After Surgery for Primary Hyperparathyroidism

Palmér¹,

Adami²,

Krusemo

et al. 1988

American Journal of Epidemiology

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A cohort of 4,163 persons reported to the nationwide Swedish Cancer Registry by reason of hyperparathyroidism was followed for up to 22 completed years (24,593 person-years of observation). The occurrence of malignant disease manifested after parathyroid surgery was investigated through computerized linkage to the entire Cancer Registry. During the entire period, the hyperparathyroidism patients suffered malignant diseases significantly more often than the background population (relative risk (RR) = 1.6, 95% confidence interval (CI) 1.5-1.8). Even if all cases with malignant diseases detected at the same time as hyperparathyroidism or during the first year after parathyroid surgery were eliminated, a significantly increased risk remained for the following years (RR = 1.4, 95% CI 1.2-1.6). A significantly increased relative risk of developing gastrointestinal cancers, endocrine tumors, kidney carcinomas, and mammary carcinomas was found. During the first postoperative year, an increased surveillance of the cohort is likely to have contributed to the increased risk, but detection bias is considered unlikely to be the only explanation for the higher risk during all subsequent years. The findings indicate that hyperparathyroidism either promotes later development of malignant tumors or that this condition and certain malignant diseases have etiologic factors in common.

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“…The prevalence of thyroid nodules has been estimated to be 4% of the population, with an incidence of 5% in persons over age 60 (Greenspan 2001 preoperatively or at neck exploration in patients with primary HPT has long been described (Attie et al 1967). Moreover, a higher incidence of thyroid tumours in patients with primary HPT has been observed since the 1970s (Kaplan et al 1971). The presence of superimposed thyroid nodules in patients with hyperfunctioning parathyroid (PT) tumour undergoing parathyroidectomy could potentially reduce the accuracy of preoperative localising procedures (Krausz et al 2000, Berczi et al 2002.…”

Section: Introductionmentioning

confidence: 99%

Hyperfunctioning parathyroid tumours in patients with thyroid nodules. Sensitivity and positive predictive value of high-resolution ultrasonography and 99mTc-sestamibi scintigraphy.

Lumachi¹,

Marzola²,

Zucchetta³

et al. 2003

Endocrine-Related Cancer

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A series of 112 consecutive patients with primary hyperparathyroidism who underwent both high-resolution neck ultrasonography (US) and Tc-pertechnetate subtraction scintigraphy (SS) prior to successful parathyroidectomy was reviewed. There were 29 (25.9%) men and 83 (74.1%) women, with a median age of 58 years (range 13-78 years). Patients were divided into two groups, according to the preoperative US findings: group A (87 patients, 77.7%) without thyroid diseases, and group B (25 patients, 22.3%) with either multinodular goitre or a solitary nontoxic thyroid nodule. In group B patients partial or total thyroidectomy was also performed, according to the intraoperative findings and frozen-section examination results. Final histopathology showed 99 (88.4%) solitary parathyroid (PT) adenomas and 3 (2.7%) PT carcinomas, while 10 (8.9%) patients had a multiglandular disease. The sensitivity and positive predictive value (PPV) were (group A vs group B) 79.8% vs 70.8% (P = 0.25) and 95.7% vs 94.4% (P = 0.58) for US, and 83.3% vs 87.0% (P = 0.47) and 95.9% vs 90.9% (P = 0.32) for SS respectively. Better but similar (P = not significant) results were obtained in patients with solitary PT tumours: 81.5% vs 77.8% (US) and 85.0 vs 94.1% (SS) sensitivity; 97.1% vs 93.3% (US) and 95.8% vs 88.9% (SS) PPV. Overall, the combination of US and SS was 92.9% sensitive (group A = 93.1%, group B = 92.0%; P = 0.55), and the PPV reached 100% in each group. In conclusion, in patients with primary hyperparathyroidism the results of both US and SS are independent of coexistent thyroid disease, especially in patients with solitary PT tumours.

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Malignant neoplasms and parathyroid adenoma

Cited by 96 publications

References 40 publications

Urinary cyclic AMP analyzed as a function of the serum calcium and parathyroid hormone in the idfferential diagnosis of hypercalcemia.

Urinary cyclic AMP analyzed as a function of the serum calcium and parathyroid hormone in the idfferential diagnosis of hypercalcemia.

Increased Risk of Malignant Diseases After Surgery for Primary Hyperparathyroidism

Hyperfunctioning parathyroid tumours in patients with thyroid nodules. Sensitivity and positive predictive value of high-resolution ultrasonography and 99mTc-sestamibi scintigraphy.

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