Surgical treatment of patients with primary hyperparathyroidism with a risk of hypercalcaemic crisis

Buła, Grzegorz; Kowalski, Grzegorz; Koziołek, Henryk; Żądło, Dominika; Bednarczyk, Adam; Buła, Adam; Gawrychowska, Agata; Gawrychowski, Jacek

doi:10.5603/ep.a2020.0032

Cited by 3 publications

(4 citation statements)

References 17 publications

(32 reference statements)

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“…The diagnosis of metastasis to the thyroid on cytology could be difficult if there were inadequate or scant cellularity precluding further evaluation or if the metastasis were mistaken for follicular nodule or poorly differentiated thyroid cancer [ 3 , 5 ]. In one study, the reported FNA accuracy rate ranged between 50 and 94.7% among different types of cancer, and 20% of cases of malignant melanoma were missed [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…The diagnostic difficulty could be due to the atypical appearance of the cells and/or inadequate clinical information to alert the cytopathologist, the potential differential diagnosis of metastatic disease, or inadequate sampling. It is not easy to make a diagnosis even on frozen sections as metastases have been confused with medullary thyroid cancer, anaplastic thyroid cancer, follicular tumor, trabecular adenoma, or epithelial cells with atypia [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

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Uveal Melanoma Metastasis to the Thyroid

Thanadar,

Siddiqui,

Bai

et al. 2023

Case Reports in Endocrinology

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Background. Around 1.2 to 3.1% of thyroid malignancies are due to metastasis. Among them, cutaneous malignant melanomas constitute 4% of malignancy metastasized to the thyroid. Uveal melanoma is uncommon, and its metastasis to the thyroid has only rarely been reported. Hereby, we describe an unusual case of uveal melanoma metastasized to the thyroid and discuss the concept of correct diagnosis. Case Report. During a routine ophthalmological examination, an 86-year-old Caucasian female was found to have retinal detachment secondary to choroidal melanoma. She was treated with gamma knife which resulted in reduction of tumor size. Three months later, she was noted to have a goiter on physical examination. Follow-up thyroid ultrasonography demonstrated numerous vascularized nodules in both lobes. The fine needle aspiration (FNA) of the left dominant nodule was indeterminate the first time and nondiagnostic the second time. FNA of the right dominant nodule was nondiagnostic twice but showed malignant cells the third time. Subsequent immunohistochemistry staining of the FNA sample from the right thyroid nodule confirmed a profile consistent with malignant melanoma. Conclusion. It should be kept in mind that a thyroid nodule detected in a patient with a diagnosis of uveal melanoma can be metastasis and that uveal melanoma diagnosis should be taken into account for the examination of the thyroid tumors of these patients. It is important to employ immunohistochemical staining FNA examination of the patient with such tumors for markers associated with a patient’s known malignancy to facilitate diagnosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Uveal Melanoma Metastasis to the Thyroid

Thanadar,

Siddiqui,

Bai

et al. 2023

Case Reports in Endocrinology

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“…A promising tool to help with diagnosis is cytofluorometry. Although due to the time consuming, expensive studies its use is limited [7,8].…”

Section: Discussionmentioning

confidence: 99%

Flow cytometric DNA analysis of parathyroid benign lesions

Gawrychowska

Kowalski

Nabrdalik

et al. 2021

Endokrynologia Polska

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Introduction: It is difficult to differentiate benign and malignant lesions just by histopathological evaluation due to lack of clear criteria of diagnosis. Moreover, the group of benign pathologies of parathyroids is not homogenous, and recurrence of symptoms of hyperparathyroidism after surgical management was also noted in this group. This complication is not always due to inappropriate surgical technique. The goal of this work was to find the relationship between cellular ploidy and proliferative activity of adenomas and hyperplasia of parathyroids and preoperative levels of calcium and parathormone in the serum of patients surgically treated for primary hyperparathyroidism. Material and methods: A total of 98 parathyroid glands were tested, of which 81 (82.7%) were from female patients and 17 (17.3%) from male; the age of the patients was from 22 to 82 years, with an average of 58 years. Results: In resected glands pathological evaluation showed the following results: in 53 (54.1%) adenoma was present, and in 45 (45.9%) there was hyperplasia. Sixty-seven of the samples (68.4%) were characterised as diploid and 31 (31.6%) as aneuploid. There is important positive correlation (r = 0.34595; p = 0.011) between the percentage of S-phase cells (% SPF) and calcium levels measured prior to surgical resection of adenoma. The further analysis of patients with adenoma characterised by aneuploidy proved a statistically valid, positive correlation between %SPF and ionised calcium levels in blood serum of patients both before (r = 0.7189; p = 0.003) and after the surgical treatment (r = 0.6313; p = 0.012). Conclusions: 1. Benign lesions of parathyroid with ploidy indicates their heterogeneity. 2. In aneuploid benign adenomas of parathyroid glands an increased percentage of cells in S phase (% SPF) correlates with a high level of calcium in serum pre-and post-parathyroidectomy.

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“…Пациентам с ПГПТ, осложненным развитием гиперкальцемического криза, рекомендовано проведение хирургического лечения в срочном порядке, после интенсивной предоперационной подготовки, направленной на коррекцию гиповолемии и снижению гиперкальциемии [310][311][312][313][314][315][316][317].…”

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