Parathyromatosis and Recurrent Hyperparathyroidism

Abstract

Parathyromatosis is an uncommon cause of hypercalcemia. We describe a case of parathyromatosis and hypercalcemia in a 38-year-old man with a history of end-stage renal disease and subtotal parathyroidectomy in which a previous parathyroid operation was implicated. The results of fine-needle aspiration and histologic examination demonstrated a neck mass consistent with parathyromatosis. We discuss parathyromatosis as a rare cause of recurrent hypercalcemia in patients with end-stage renal disease and in those who have undergone previous parathyroid operations. We also characterize the iatrogenic and the embryologic pathogenetic factors involved.

Persistent secondary hyperparathyroidism caused by parathyromatosis and supernumerary parathyroid glands in a patient on haemodialysis

“…Parathyromatosis and supernumerary parathyroid glands are very rare causes of persistent SHPT after parathyroidectomy in patients undergoing haemodialysis. The form of parathyromatosis is speculated to be either the spillage and seeding of the parathyroid tissue during parathyroid surgery (type 2) or the development of embryonic rests of parathyroid tissue under physiological stimuli (type 1) [9][10][11][12]. In our case, one of the causes of the persistent hyperparathyroidism was considered to be type 2 parathyromatosis because both implanted autografts in the forearm and un-implanted subcutaneous seeding were observed.…”

Hiperparatiroidismo persistente debido a paratiromatosis

“…En su estudio, sólo 4 de 10 pacientes fueron diagnosticados satisfactoriamente de paratiromatosis preoperatoriamente siendo la ecografía la técnica más efectiva 6 . La ecografía se considera la técnica más utilizada, pero no hay descritas imágenes ecográficas típicas para la paratiromatosis 7 . La aspiración con aguja fina (PAAF) puede ayudarnos a establecer el diagnóstico, aunque el temor a la siembra lo hace innecesario.…”

Re-explorative Parathyroid Surgery for Persistent and Recurrent Primary Hyperparathyroidism

“…For this reason care should be used when removing abnormal parathyroid tissue to avoid spillage of cells. 18 Preoperative localization studies are essential in the evaluation of persistent or recurrent HPT. In our study, all patients undergoing redo surgery had sestamibi and US scanning although neither was always helpful.…”