Supernumerary parathyroid glands in hyperparathyroidism associated with multiple endocrine neoplasia type 1

d’Alessandro, André Fernandes; Montenegro, Fábio Luiz de Menezes; Brandão, Lenine Garcia; Lourenço, Delmar M.; Toledo, Sérgio de Almeida; Cordeiro, Anói Castro

doi:10.1016/s2255-4823(12)70202-3

Cited by 3 publications

(3 citation statements)

References 21 publications

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“…Improvements in PTH levels and an eventual recurrence of HPT may occur in some patients who undergo total parathyroidectomy because of hyperplasia of a supernumerary parathyroid gland, especially in cases of familial HPT syndromes, such as MEN1 (12). In the present case, besides the normal calcium metabolism, the PTH gradient in the arm graft proved that the cryopreserved parathyroid tissue was functional.…”

Section: Discussionsupporting

confidence: 51%

“…Therefore, the acceptable surgical options for the treatment of HPT associated with familial or sporadic MEN1 are subtotal parathyroidectomy or total parathyroidectomy with an immediate autograft (20). Both techniques carry the risk of permanent hypoparathyroidism (12). The possibility of tissue cryopreservation is attractive in the context of multiglandular disease because, in many cases, tissue cryopreservation offers a solution for permanent hypoparathyroidism, even after subtotal parathyroidectomy.…”

Section: Discussionmentioning

confidence: 99%

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Successful parathyroid tissue autograft after 3 years of cryopreservation: a case report

Leite¹,

N.²,

Arap³

et al. 2014

Arq Bras Endocrinol Metab

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SUMMARYAfter a total parathyroidectomy, well-established protocols for the cryopreservation of parathyroid tissue and for the delayed autograft of this tissue exist, especially in cases of secondary hiperparathyroidism (HPT) or familial or sporadic parathyroid hyperplasia. Although delayed autografts are effective, the published success rates vary from 10% to 83%. There are numerous factors that influence the viability, and therefore the success, of an autograft, including cryopreservation time. Certain authors believe that the tissue is only viable for 24 months, but there is no consensus on how long the parathyroid tissue can be preserved. A 63-year-old male who was diagnosed with sporadic multiple endocrine neoplasia type 1 and primary hyperparathyroidism, and was submitted to a total parathyroidectomy and an autograft in the forearm. The implant failed, and the patient developed severe hypoparathyroidism in the months following the surgery. Thirty-six months after the total parathyroidectomy, the cryopreserved autograft was successfully transplanted, and hypoparathyroidism was reversed (most recent systemic parathyroid hormone, PTH, of 36 pg/mL, and total calcium of 9.1 mg/dL; no oral calcium supplementation). The case presented here indicates that cryopreserved parathyroid tissue may remain viable after 24 months in storage, and may retain the capacity to reverse permanent postsurgical hypoparathyroidism. These data provide reasonable evidence that the time limit for cryopreservation remains undetermined and that additional research would be valuable. Arq Bras Endocrinol Metab. 2014;58(3):313-6 SUMÁRIO O implante de tecido paratireoideano criopreservado após paratireoidectomia total é um procedimento bem estabelecido e, embora tenha sua eficácia comprovada, as taxas de sucesso variam de 10% a 83% na literatura. O tempo de criopreservação é um dos diversos fatores relacionados ao sucesso do implante. Alguns autores defendem que o tecido permanece viável até 24 meses de criopreservação, no entanto, não há consenso. Homem de 63 anos diagnosticado com neoplasia endócrina múltipla tipo I e hiperparatireoidismo primário foi submetido a paratireoidectomia total e autoimplante em membro superior. O implante falhou e o paciente desenvolveu hipoparatireoidismo. Após 36 meses da paratireoidectomia total, foi realizado o implante de paratireoide criopreservada, com sucesso. O hipoparatireoidismo foi revertido e o paciente permanece sem suplementação de cálcio e PTH sistêmico de 36 pg/mL e cálcio total de 9,1 mg/dL. O caso apresentado mostra que o tecido paratireoideano criopreservado pode permanecer viável após 24 meses e há possibilidade de reverter o hipoparatireoidismo pós--cirúrgico. Isso traz evidência de que o tempo limite de criopreservação permanece incerto e que novas pesquisas seriam de grande valia. Arq Bras Endocrinol Metab. 2014;58(3):313-6

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Section: Discussionsupporting

confidence: 51%

Section: Discussionmentioning

confidence: 99%

Successful parathyroid tissue autograft after 3 years of cryopreservation: a case report

Leite¹,

N.²,

Arap³

et al. 2014

Arq Bras Endocrinol Metab

View full text Add to dashboard Cite

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“…Most people have four parathyroid glands; this patient had five, meaning that he had one supernumerary parathyroid gland . The reported rate of supernumerary parathyroid glands is around 2.5% to 13% . Studies have shown that SHPT patients undergoing TPTX had an incidence of ectopic parathyroid glands of about 15%, and these glands are mainly distributed around the thymus, esophageal tissue, carotid sheath, and mediastinum .…”

Section: Discussionmentioning

confidence: 86%

Sixty‐Two‐Year‐Old Male Suffering From Uremic Leontiasis Ossea Caused by Severe Secondary Hyperparathyroidism

et al. 2018

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Secondary hyperparathyroidism (SHPT) is a long‐term complication of chronic kidney disease–mineral and bone disorder (CKD‐MBD). SHPT is characterized by hyperplasia of the parathyroid glands and abnormal secretion of parathyroid hormones (PTH), calcium and phosphorous metabolic disorders, renal osteodystrophy, vascular and soft tissue calcification, malnutrition, and other multiple system complications, which can seriously affect the quality of life of the patient and increase the risk of cardiovascular disease and mortality rate. Uremic leontiasis ossea (ULO) is a medical condition only rarely encountered clinically. SHPT causes craniofacial bone deformity accompanied by lesions of the nerve, cardiovascular, respiratory, bone, or other systems within the body. The case discussed here is related to severe SHPT. A 62‐year‐old male patient was suffering from leontiasis ossea, pectus excavatum, vascular calcification, spontaneous bone fractures, and lower limb deformities. He was undergoing hemodialysis and given total parathyroidectomy (TPTX) with autotransplantation (AT). We further analyzed the multivariate therapeutic effects of TPTX on this patient in order to provide clinical data for standardized treatment of individuals with CKD‐MBD. © 2018 The Authors JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.

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Challenging Differential Diagnosis of Hypergastremia and Hyperglucagonemia with Chronic Renal Failure: Report of a Case with Multiple Endocrine Neoplasia Type 1

et al. 2017

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A 53-year-old woman developed end-stage renal failure during a 15-year clinical course of primary hyperparathyroidism and was referred to our hospital for evaluation of suspected multiple endocrine neoplasia type 1 (MEN1). Genetic testing revealed a novel deletion mutation at codon 467 in exon 10 of the MEN1 gene. Systemic and selective arterial calcium injection (SACI) testing revealed hyperglucagonemia and hypergastrinemia with positive gastrin responses. A pathological examination revealed glucagonoma and a lymph node gastrinoma. The findings in this case indicate the importance of early diagnosis of MEN1 and demonstrate the utility of systemic and SACI testing in renal failure cases.

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Supernumerary parathyroid glands in hyperparathyroidism associated with multiple endocrine neoplasia type 1

Cited by 3 publications

References 21 publications

Successful parathyroid tissue autograft after 3 years of cryopreservation: a case report

Successful parathyroid tissue autograft after 3 years of cryopreservation: a case report

Sixty‐Two‐Year‐Old Male Suffering From Uremic Leontiasis Ossea Caused by Severe Secondary Hyperparathyroidism

Challenging Differential Diagnosis of Hypergastremia and Hyperglucagonemia with Chronic Renal Failure: Report of a Case with Multiple Endocrine Neoplasia Type 1

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