Search Our Scientific Publications & Authors

Nihon Shokakibyo Gakkai Zasshi 2021 ;118(5):480-489

Division of Pathology, Department of Diagnosis Pathology, University of Miyazaki Hospital.

A 66-year-old man was admitted to our department with hypercalcemia, pancreatic and liver tumors, and periportal lymph node enlargement. Contrast-enhanced computed tomography revealed a tumor in the pancreatic tail and the right hepatic lobe along with periportal lymphadenopathy. Laboratory data revealed hypercalcemia and high serum parathyroid hormone-related protein (PTHrP) levels. Read More

Clin Case Rep 2021 Apr 24;9(4):2492-2493. Epub 2021 Feb 24.

Department of Surgery "Hygeia Hospital" Athens Greece.

A 78 years-old woman was found with worsening hypercalcemia, osteopenia and memory loss during the past 2 years. Multiple, repeated imaging studies failed to reveal the etiology of the primary hyperparathyroidism. Bilateral neck exploration revealed a 4. Read More

BMC Endocr Disord 2021 May 1;21(1):90. Epub 2021 May 1.

Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, 610041, Chengdu, China.

Background: Hypercalcemia associated with acromegaly is mostly parathyroid hormone (PTH)-dependent, being caused by parathyroid hyperplasia or adenoma, which are common in individuals with multiple endocrine adenomatosis-1 (MEN-1). The rare occurrence of non-PTH-dependent hypercalcemia associated with acromegaly is attributable to complex factors involving increased intestinal calcium absorption, enhanced bone calcium release, and reduced urinary calcium elimination. Although patients with acromegaly often have mild hyperphosphatemia and hypercalciuria, clinically significant hypercalcemia is extremely rare. Read More

Langenbecks Arch Surg 2021 Apr 30. Epub 2021 Apr 30.

Medical Campus University of Oldenburg, School of Medicine and Health Sciences, University Hospital for Visceral Surgery, Pius-Hospital Oldenburg, Georgstr. 12, 26121, Oldenburg, Germany.

Purpose: In primary hyperparathyroidism (PHPT), intraoperative localization of the parathyroid adenoma can be challenging, especially in cases of negative preoperative imaging. Since a focused unilateral parathyroidectomy has benefits compared to a conventional bilateral neck exploration, the question arises whether adenoma size prediction can facilitate a targeted approach. We investigated whether single parathyroid adenoma size can be estimated using preoperative parathyroid hormone (PTH), calcium, and phosphate in patients with PHPT. Read More

J Clin Med 2021 Apr 13;10(8). Epub 2021 Apr 13.

Department of Endocrine Surgery, Endokrines Zentrum Stuttgart, Diakonie-Klinikum Stuttgart, 70176 Stuttgart, Germany.

Background: The diagnostic performance of [F]fluoro-ethylcholine-PET-CT&4D-CT (FEC-PET&4D-CT) to identify parathyroid adenomas (PA) was analyzed when ultrasound (US) or MIBI-Scan (MS) failed to localize. Postsurgical one year follow-up data are presented.

Methods: Patients in whom US and MS delivered either incongruent or entirely negative findings were subjected to FEC-PET&4D-CT and cases from July 2017 to June 2020 were analyzed, retrospectively. Read More

Biomedicines 2021 Apr 6;9(4). Epub 2021 Apr 6.

Department of Radiology, Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.

With increasing use of minimally invasive parathyroidectomy (PTx) over traditional bilateral neck exploration in patients with primary hyperparathyroidism (PHPT), accurate preoperative localization has become more important to enable a successful surgical outcome. Traditional imaging techniques such as ultrasound (US) and sestamibi scintigraphy (MIBI) and newer techniques such as parathyroid four-dimension computed tomography (4D-CT), positron emission tomography (PET), and magnetic resonance imaging (MRI) are available for the clinician to detect the diseased gland(s) in the preoperative workup. Invasive parathyroid venous sampling may be useful in certain circumstances such as persistent or recurrent PHPT. Read More

Endocrinol Diabetes Metab Case Rep 2021 Apr 1;2021. Epub 2021 Apr 1.

Royal Wolverhampton Hospital NHS TrustWolverhampton, UK.

Summary: Primary hyperparathyroidism requires a surgical approach to achieve a long-term cure. However, post-surgical recurrence significantly complicates the management of this condition. A number of causes for recurrent disease are well understood and several diagnostic modalities exist to localise the culprit parathyroid adenoma although none of them is efficacious in localisation of the recurrent lesion. Read More

AACE Clin Case Rep 2021 Jan-Feb;7(1):51-56. Epub 2020 Nov 28.

Division of Pediatric Endocrinology, New York Presbyterian Brooklyn Methodist Hospital, Brooklyn, New York.

Objective: Primary hyperparathyroidism secondary to an ectopic parathyroid adenoma is rare among children and adolescents.

Methods: We describe the case of an 11-year-old girl with incidentally diagnosed primary hyperparathyroidism secondary to an intrathymic parathyroid adenoma and performed a review of the related literature.

Results: Technetium sestamibi single-photon emission computerized tomography/computed tomography and 4-dimensional computed tomography confirmed the ectopic location of the adenoma. Read More

Rozhl Chir 2021 ;100(3):133-137

Introduction: Parathyroid cancer is a rare endocrine malignancy. These tumors are typically functional, causing severe hypercalcemia due to primary hyperparathyroidism. Nonfunctional parathyroid cancer with normal serum calcium and parathyroid hormone levels is extremely rare. Read More

AJR Am J Roentgenol 2021 Apr 28:1-12. Epub 2021 Apr 28.

Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, UT.

The purpose of this article is to review the clinical manifestations, endocrine tumors types, and multimodality diagnostic tools available to physicians involved in the management of patients with multiple endocrine neoplasia (MEN) syndrome, in addition to discussing relevant imaging findings and appropriate imaging follow-up. Thorough knowledge of the spectrum of tumors associated with gene mutations aids in the screening, diagnostic workup, and posttreatment monitoring of patients with MEN-related gene mutations. Read More

Turk J Med Sci 2021 Apr 26. Epub 2021 Apr 26.

Introduction: This study aimed to evaluate the effect of sono-scintigraphic correlation on the success of minimal invasive parathyroidectomy (MIP) via surgeon performed continuous intraoperative sonographic guidance in patients operated for primary hyperparathyroidism(PHPT) without intact parathormone (PTH) measurement.

Materials And Methods: A retrospective analysis of a prospective database was conducted to review patients who underwent MIP (July 2017-October 2019). The screened parameters were preoperative PTH level, preoperative ultrasonography (US), preoperative scintigraphy, intraoperative US, intraoperative frozen section analysis, postoperative PTH level and permanent pathology report. Read More

J Med Case Rep 2021 Apr 13;15(1):198. Epub 2021 Apr 13.

1st Surgical Department, 424 General Military Hospital, Ring Road, 56429, EfkarpiaThessaloniki, Greece.

Background: Double adenomas (DA) represents a distinct clinical entity of primary hyperparathyroidism (PHPT). DA may follow various embryologic distribution patterns and could be supernumerary and/or ectopic.

Case Presentation: We describe the first case of PHPT which comes as a result of double ipsilateral adenoma, of which one was both ectopic and supernumerary. Read More

Eur J Nucl Med Mol Imaging 2021 Apr 10. Epub 2021 Apr 10.

EANM Thyroid Committee, Vienna, Austria.

Introduction: Nuclear medicine parathyroid imaging is important in the identification of hyperfunctioning parathyroid glands in primary hyperparathyroidism (pHPT), but it may be also valuable before surgical treatment in secondary hyperparathyroidism (sHPT). Parathyroid radionuclide imaging with scintigraphy or positron emission tomography (PET) is a highly sensitive procedure for the assessment of the presence and number of hyperfunctioning parathyroid glands, located either at typical sites or ectopically. The treatment of pHPT is mostly directed toward minimally invasive parathyroidectomy, especially in cases with a single adenoma. Read More

BMC Urol 2021 Apr 1;21(1):51. Epub 2021 Apr 1.

Medical Oncology, Ohio State University James Cancer Hospital, Suite 1335 Lincoln Tower, 1800 Cannon Drive, Columbus, OH, 43210, USA.

Background: Severe hypercalcemia is often associated with uncontrolled malignancy through several mechanisms. However, calcitriol-mediated hypercalcemia is a rare etiology for advanced solid tumors.

Case Presentation: We report a case of calcitriol-mediated hypercalcemia secondary to immune checkpoint inhibition in a responder with metastatic clear cell renal cell carcinoma (ccRCC). Read More

Cureus 2021 Feb 25;13(2):e13550. Epub 2021 Feb 25.

Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, SAU.

Background Accurate preoperative radiological localization of parathyroid pathologies paves the way to enable less invasive surgical procedures. Results on the accuracy of the different diagnostic measures are conflicting. Also, little is known about the most common location of parathyroid lesions. Read More

Case Rep Oncol 2021 Jan-Apr;14(1):29-33. Epub 2021 Feb 18.

Division of Endocrinology, Department of Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.

Primary hyperparathyroidism is a relatively common endocrine disorder, affecting 7 out of 1,000 adults. The median age at onset is the 6th decade of life. Our objective was to present a young patient with primary hyperparathyroidism who has a positive mutation. Read More

Endocr Pract 2021 Mar 10;27(3):174-184. Epub 2020 Dec 10.

Department of Otolaryngology-Head and Neck Surgery, Division of Thyroid and Parathyroid Endocrine Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts.

Objectives: To provide a clinical disease state review of recent relevant literature and to generate expert consensus statements regarding the breadth of pediatric thyroid cancer diagnosis and care, with an emphasis on thyroid surgery. To generate expert statements to educate pediatric practitioners on the state-of-the-art practices and the value of surgical experience in the management of this unusual and challenging disease in children.

Methods: A literature search was conducted and statements were constructed and subjected to a modified Delphi process to measure the consensus of the expert author panel. Read More

World J Surg 2021 Mar 27. Epub 2021 Mar 27.

Department of Surgery, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.

Background: Tertiary hyperparathyroidism following kidney transplantation is most commonly characterized by 4-gland hyperplasia, but single and double adenomatous disease has been demonstrated in this population as well. It is unknown whether preoperative imaging can assist in identifying patients who may qualify for focused surgery for adenomatous disease.

Materials And Methods: We performed a retrospective review of our patient database from 1998-2018 for patients with tertiary hyperparathyroidism following renal transplant. Read More

EJNMMI Res 2021 Mar 26;11(1):32. Epub 2021 Mar 26.

Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands.

Background: Identifying the correct location of a parathyroid adenoma in patients with primary hyperparathyroidism (pHPT) is crucial as it can guide surgical treatment. This study aimed to determine the diagnostic performance of C-choline PET/CT in patients with pHPT as a next in-line scan after primary negative or discordant first-line imaging.

Methods: This was a retrospective single-center cohort study. Read More

Endocrine 2021 Mar 25. Epub 2021 Mar 25.

Imaging Institute of Southern Switzerland, Bellinzona, Switzerland.

Am J Surg 2021 Mar 13. Epub 2021 Mar 13.

Department of Electrical and Computer Engineering, Faculty of Applied Science, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address:

Background: The aim of this study was to develop a low-cost prototype near-infrared fluorescence device that enables contrast-free, real time, high-resolution intraoperative visualization of normal and pathological parathyroid glands (PGs) by imaging their autofluorescence (AF).

Methods: A novel near-infrared parathyroid AF (NIR-PAF) imaging device with visible laser PG targeting was developed. The device was evaluated during parathyroid and thyroid operations in a pilot clinical study. Read More

Surg Innov 2021 Mar 20:15533506211001236. Epub 2021 Mar 20.

Department of Digestive and Endocrine Surgery, University Hospital of Strasbourg, Strasbourg, France.

. Preoperative imaging in primary hyperparathyroidism (PHPT) is essential for planning of parathyroidectomy-particularly for selection of a minimally invasive approach. The objective of this cohort study was to evaluate the diagnostic precision of 3D virtual neck exploration (3D-VNE), to evaluate its impact on choice of surgical approach, and to document the correlation with long-term outcomes. Read More

World J Surg 2021 Mar 18. Epub 2021 Mar 18.

Rambam-Health Care Campus, Haifa, Israel.

Background: Neck ultrasound (US) and Technetium-99 m Sestamibi (MIBI) scan are the most commonly used imaging studies for preoperative localization of parathyroid adenomas. The aim of this study was to determine the added value of MIBI scan and its effect on the operative plan via a hypothetical model where a stepwise approach is conducted and MIBI is considered only after the ultrasound is evaluated.

Methods: Patients who underwent parathyroidectomy for primary hyperparathyroidism (PHPT) between 2012 and 2019 at two tertiary centers were included. Read More

Indian J Radiol Imaging 2020 Oct-Dec;30(4):524-528. Epub 2021 Jan 13.

Department of Radiology and Nuclear Imaging, Medanta, The Medicity, Gurgaon, Haryana, India.

Parathyroid cyst is a rare clinical entity and often presents as a diagnostic challenge, especially when presents in conjunction with a coexistent parathyroid adenoma. Patient with primary hyperparathyroidism had presented with a localised left inferior parathyroid adenoma with a coexistent right inferior parathyroid cyst which was initially missed on routine ultrasound and sestamibi scan. Suspicion of right inferior thyroid cyst was raised on ultrasound done by a dedicated parathyroid ultrasonologist. Read More

Eur J Radiol 2021 May 5;138:109625. Epub 2021 Mar 5.

Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.

Background: Minimally invasive parathyroid surgery is the standard of care in patients with Primary Hyperparathyroidism (PHPT) which requires accurate preoperative localization. Of all the available imaging modalities, 4DCT is considered the best modality for localization, however it entails the risk of ionizing radiation. To circumvent this 4DMRI was evaluated for parathyroid lesion localization. Read More

Indian J Nucl Med 2020 Oct-Dec;35(4):333-335. Epub 2020 Oct 21.

Department of Nuclear Medicine, PET/CT and Radionuclide Therapy, Kovai Medical Center and Hospital Limited, Coimbatore, Tamil Nadu, India.

Parathyroid carcinoma (PC) is a rare endocrine carcinoma. It is one of the rare causes for primary hyperparathyroidism. It is very uncommon in individuals with secondary or tertiary hyperparathyroidism. Read More

J Int Med Res 2021 Feb;49(2):300060521994420

Department of Nuclear Medicine, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

We present a case of a 34-year-old man who was admitted to our hospital with a six-month history of nausea and vomiting that had worsened over the past two weeks. Diagnosis of primary hyperparathyroidism (PHPT) due to a single parathyroid adenoma was confirmed by laboratory results and imaging but following pharmacological therapy the patient developed a dry cough. Single-photon emission tomography/computed tomography (SPECT/CT) with technetium-99m-diphosphonate (Tc-MDP) was used to assist in the diagnosis and results showed diffuse metastatic microcalcification in the lungs and stomach. Read More

BJS Open 2021 Jan;5(1)

Department of Thoracic and Endocrine Surgery and Faculty of Medicine, University Hospitals of Geneva, Geneva, Switzerland.

Background: Primary hyperparathyroidism (pHPT) is a common endocrine pathology, and it is due to a single parathyroid adenoma in 80-85 per cent of patients. Near-infrared autofluorescence (NIRAF) has recently been used in endocrine surgery to help in the identification of parathyroid tissue, although there is currently no consensus on whether this technique can differentiate between normal and abnormal parathyroid glands. The aim of this study was to describe the autofluorescence pattern of parathyroid adenoma in pHPT. Read More

BMJ Case Rep 2021 Feb 12;14(2). Epub 2021 Feb 12.

Department of Otolaryngology/HNS, Louisiana State University Health Sciences Center Shreveport, Shreveport, Louisiana, USA

Ectopic or supernumerary parathyroid tissue has been generally described in the literature in cases found during workup for parathyroid adenoma. We present two unique cases of intratracheal parathyroid gland, a rare occurrence that has not yet been described in the literature. In both cases, the masses were found incidentally and showed no clinical or laboratory evidence of hyperparathyroidism. Read More

Z Gastroenterol 2021 Feb 8;59(2):143-148. Epub 2021 Feb 8.

Klinik für Innere Medizin, Albertinen-Krankenhaus, Hamburg, Germany.

Background:  Neuroendocrine tumors (NET) diagnosed during pregnancy are extremely rare. This case report describes diagnosis and treatment of a metastasized pancreas NET that became symptomatic in the second trimester.

Case Description:  A 33-year-old patient presented to the emergency department in the 19 week of pregnancy (WOP) with persistent diarrhea. Read More