Parathyroid Gland

Elgazzar, Abdelhamid H.; Alenezi, Saud

doi:10.1007/978-3-319-06112-2_8

Cited by 3 publications

(5 citation statements)

References 70 publications

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“…It is particularly helpful in the identification and characterisation of single-gland disease (adenoma or rare carcinoma) although it may also detect multigland parathyroid disease (usually hyperplasia) allowing for the appropriate surgical approach 4 6 7 51 106–108 111 112 114 115. In patients with a predisposition for multigland disease (eg, those with MEN), parathyroid imaging is perhaps most useful in the localisation of recurrent disease as their initial surgery usually entails a four gland parathyroid exploration with resection of most of the parathyroid tissue 116 117.…”

Section: Radiological Investigationsmentioning

confidence: 99%

“…Although several imaging modalities have been described, neck ultrasound and 99 technetium-labelled sestamibi ( 99m Tc-sestamibi) scintigraphy are currently the most commonly used radiological tools (figure 2). 4 6 7 51 106–108 111 112 99mTc-sestamibi is taken up by both parathyroid and thyroid tissue, and its uptake is generally increased and prolonged in functioning neoplastic or hyperplastic parathyroid gland(s) (figure 2). 4 6 7 51 106–108 111 112 In addition, it has the advantage of localising ectopic parathyroid tissue 4 5 6 7 51 106–108 111 112.…”

Section: Radiological Investigationsmentioning

confidence: 99%

“…4 6 7 51 106–108 111 112 99mTc-sestamibi is taken up by both parathyroid and thyroid tissue, and its uptake is generally increased and prolonged in functioning neoplastic or hyperplastic parathyroid gland(s) (figure 2). 4 6 7 51 106–108 111 112 In addition, it has the advantage of localising ectopic parathyroid tissue 4 5 6 7 51 106–108 111 112. Recently, dual-tracer subtraction using 99m Tc-sestamibi in combination with radioactive iodine ( 123 I) has also been proposed to separate parathyroid uptake of sestamibi from thyroid uptake to achieve better visualisation of the functioning parathyroid tissue 4 6 7 51 106–108 111–119…”

Section: Radiological Investigationsmentioning

confidence: 99%

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Clinicopathological correlates of hyperparathyroidism

2015

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Hyperparathyroidism is a common endocrine disorder with potential complications on the skeletal, renal, neurocognitive and cardiovascular systems. While most cases (95%) occur sporadically, about 5% are associated with a hereditary syndrome: multiple endocrine neoplasia syndromes (MEN-1, MEN-2A, MEN-4), hyperparathyroidism-jaw tumour syndrome (HPT-JT), familial hypocalciuric hypercalcaemia (FHH-1, FHH-2, FHH-3), familial hypercalciuric hypercalcaemia, neonatal severe hyperparathyroidism and isolated familial hyperparathyroidism. Recently, molecular mechanisms underlying possible tumour suppressor genes (MEN1, CDC73/HRPT2, CDKIs, APC, SFRPs, GSK3β, RASSF1A, HIC1, RIZ1, WT1, CaSR, GNA11, AP2S1) and proto-oncogenes (CCND1/PRAD1, RET, ZFX, CTNNB1, EZH2) have been uncovered in the pathogenesis of hyperparathyroidism. While bi-allelic inactivation of CDC73/HRPT2 seems unique to parathyroid malignancy, aberrant activation of cyclin D1 and Wnt/β-catenin signalling has been reported in benign and malignant parathyroid tumours. Clinicopathological correlates of primary hyperparathyroidism include parathyroid adenoma (80–85%), hyperplasia (10–15%) and carcinoma (<1–5%). Secondary hyperparathyroidism generally presents with diffuse parathyroid hyperplasia, whereas tertiary hyperparathyroidism reflects the emergence of autonomous parathyroid hormone (PTH)-producing neoplasm(s) from secondary parathyroid hyperplasia. Surgical resection of abnormal parathyroid tissue remains the only curative treatment in primary hyperparathyroidism, and parathyroidectomy specimens are frequently encountered in this setting. Clinical and biochemical features, including intraoperative PTH levels, number, weight and size of the affected parathyroid gland(s), are crucial parameters to consider when rendering an accurate diagnosis of parathyroid proliferations. This review provides an update on the expanding knowledge of hyperparathyroidism and highlights the clinicopathological correlations of this prevalent disease.

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Section: Radiological Investigationsmentioning

confidence: 99%

Section: Radiological Investigationsmentioning

confidence: 99%

Section: Radiological Investigationsmentioning

confidence: 99%

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Clinicopathological correlates of hyperparathyroidism

2015

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“…[23] Although experienced neck surgeons can achieve nearly 95%success rate of parathyroidectomy after bilateral neck exploration without prior localizing study,[45] a preoperative localization study would decrease operative time and morbidity. The new trend is toward minimally invasive surgery which depends not only on surgeons' experience but also on a sensitive and accurate imaging technique.…”

Section: Introductionmentioning

confidence: 99%

“…Since a single parathyroid adenoma is an underlying abnormality in about 85%of cases of primary hyperparathyroidism,[ 1 ] there would be no need to explore both sides of the neck with potentially increased morbidity if a sensitive imaging modality could localize the abnormal gland preoperatively. [ 2 3 ] Although experienced neck surgeons can achieve nearly 95%success rate of parathyroidectomy after bilateral neck exploration without prior localizing study,[ 4 5 ] a preoperative localization study would decrease operative time and morbidity. The new trend is toward minimally invasive surgery which depends not only on surgeons' experience but also on a sensitive and accurate imaging technique.…”

Section: Introductionmentioning

confidence: 99%

Ultrastructure of hyperfunctioning parathyroid glands: Does it explain various patterns of 99mTc-sestamibi uptake

et al. 2017

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The aim of this study was to correlate the uptake of 99mTc-methoxy-isobutyl-isonitrile (MIBI) with ultra-structural features of parathyroid adenomas. Twenty patients with proven primary hyperparathyroidism were evaluated prospectively. Preoperative double-phase 99mTc-MIBI scintigraphy was performed in all patients and the degree of tracer uptake by the parathyroid lesions was assessed visually and semi-quantitatively. The excised glands were examined histologically and ultrastructurally, and their features were correlated with the degree of the radiotracer uptake. At surgery, 21 parathyroid adenomas were removed (double adenoma in one patient and a solitary adenoma in each of the remaining 19 patients). 99mTc-MIBI scan detected 18 of the 21 adenomas. There was positive correlation between the degree of 99mTc-MIBI uptake and the mitochondrial contents of the parathyroid adenoma cells. Four adenomas with intense uptake had high content of mitochondria in the cells. The three false-negative scans had low-to-moderate mitochondrial content. 99mTc-MIBI uptake is related to the mitochondrial content of the parathyroid adenoma cells.

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