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Int J Surg Case Rep 2022 Jun 10;96:107296. Epub 2022 Jun 10.

Department of General Surgery, Hamad General Hospital, Doha, Qatar. Electronic address:

Introduction: Atypical parathyroid adenomas (APA) are an uncommon cause of hypercalcemia and comprise a minority of parathyroid adenomas.

Presentation Of Cases: Case 1 - Egyptian male, 48 years old with history of type 2 diabetes mellitus, incidentally discovered increased serum of calcium level on routine investigation, was diagnosed as PHPT, US and MIBI scan showed large left inferior parathyroid adenoma, focused exploration and excision of the APA was undertaken, histopathology confirmed APA. Case 2 - Egyptian male, 60 years old, cardiac patient with history of diabetes, hypertension and multiple cardiac interventions, had nausea, vomiting, constipation abdominal pain, polyuria, polydipsia, and history of passing renal stones, hypercalcemia workup showed primary hyperparathyroidism (PHPT), MIBI was negative and SPECT scan suggested right inferior parathyroid adenoma, focused exploration and excision of the APA was undertaken, histopathology confirmed APA. Read More

J Int Med Res 2022 Jun;50(6):3000605221106419

Department of Endocrinology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, P.R. China.

An uncommon cause of primary hyperparathyroidism is a cystic parathyroid adenoma. This paper describes two patients with hypercalcemia and right knee disease. Their serum calcium concentration was high, phosphorus concentration was low, and parathyroid hormone (PTH) concentration was high. Read More

Acta Clin Croat 2021 Dec;60(4):617-626

1Department of Oncology and Nuclear Medicine, Sestre milosrdnice University Hospital Center, Zagreb, Croatia; 2University of Applied Health Sciences, Zagreb, Croatia; 3Department of Radiology and Nuclear Medicine, PET/CT Center, Medikol Polyclinic, Zagreb, Croatia; 4Department of Nuclear Medicine and Radiology, Martini Hospital, Groningen, The Netherlands; 5Department of Surgery, University Hospital for Tumors, Sestre milosrdnice University Hospital Center, Zagreb, Croatia; 6School of Dental Medicine, University of Zagreb, Zagreb, Croatia.

The bone health guidelines for breast cancer (BC) patients recommend bone mineral density (BMD) testing. Patients with low BMD and elevated serum calcium levels (SCLs) are further evaluated for primary hyperparathyroidism (PHPT). We aimed to determine the prevalence of PHPT in treated BC patients with low BMD and analyze the association of SCLs with histopathologic tumor features and cancer treatment. Read More

PET Clin 2022 Jul;17(3):343-367

Radiation Medicine Centre (B.A.R.C), Tata Memorial Centre Annexe, Parel, Mumbai, India; Homi Bhabha National Institute, Mumbai, India. Electronic address:

Endocrine neoplasms and malignancies are a diverse group of tumors with varied clinical, histopathologic, and functional features. These tumors vary from sporadic to hereditary, isolated entities to multiple neoplastic syndromes, functioning and non functioning tumors, unifocal locally invasive, and advanced to multifocal tumors with disseminated distant metastases. The presence of various specific biomarkers and specific receptor targets serves as valuable tools for diagnosis, prognosis, and management. Read More

Eur J Endocrinol 2022 Jun 1. Epub 2022 Jun 1.

A Sanchez-Crespo, Department of Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, 171 76, Sweden.

Objective: Successful preoperative image localisation of all parathyroid adenomas (PTA) in patients with primary hyperparathyroidism (pHPT) and multiglandular disease (MGD) remains challenging. We investigate whether a machine learning classifier (MLC) could predict the presence of overlooked PTA at preoperative localisation with 99mTc-Sestamibi-SPECT/CT in MGD-patients.

Design: Retrospective study from a single tertiary referral hospital initially including 349 patients with biochemically confirmed pHPT and cured after surgical parathyroidectomy. Read More

Updates Surg 2022 Jun 4. Epub 2022 Jun 4.

Department of General Surgery, Division Endocrine Surgery, Ege University Hospital, Izmir, Turkey.

Freehand single photon emission computed tomography (fhSPECT) is a technique that is used to monitor body's radioactivity intraoperatively. Accordingly, in this study, the feasibility of using fhSPECT for intraoperative 3D mapping in radioguided parathyroidectomy has been assessed. Patients, who were diagnosed with primary hyperparathyroidism consecutively, were scanned intraoperatively using fhSPECT to locate parathyroid adenomas before surgical procedure. Read More

J Clin Med 2022 May 23;11(10). Epub 2022 May 23.

Department of Nuclear Medicine, University Hospital, LMU Munich, 81377 Munich, Germany.

Primary hyperparathyroidism (pHPT) is a common endocrine disorder due to hyperfunctioning parathyroid glands. To date, the only curing therapy is surgical removal of the dysfunctional gland, making correct detection and localization crucial in order to perform a minimally invasive parathyroidectomy. F-Fluorocholine positron emission tomography/computed tomography (F-FCH PET/CT) has shown promising results for the detection of pHPT, suggesting superiority over conventional imaging with ultrasounds or scintigraphy. Read More

Ear Nose Throat J 2022 May 21:1455613221103082. Epub 2022 May 21.

Department of General Surgery (Thyroid Surgery), 556508The Affiliated Hospital of Southwest Medical University, Luzhou, China.

The occurrence of ectopic intrathyroidal parathyroid adenoma (EPTA) is very rare, which causes some difficulties in diagnosis and complicates treatment. In addition, the occurrence of EPTA with nodular goiter (NG) is rare, which makes diagnosis difficult and requires the assistance of clinical evidence, imaging data, and cytological examination results. Therefore, we present a patient with a final diagnosis of ETPA with NG. Read More

J Endocr Soc 2022 Jun 7;6(6):bvac071. Epub 2022 May 7.

Division of Endocrinology, Department of Pediatrics, Boston Children's Hospital, Boston, MA 02115, USA.

Primary hyperparathyroidism has been reported in pediatric patients presenting with slipped capital femoral epiphysis (SCFE), but never in patients with ectopic parathyroid adenoma. A 12-year-old boy with obesity and autism spectrum disorder presented with a limp and was found to have bilateral SCFE. Calcium was elevated to 12. Read More

Eur Thyroid J 2022 Jun 21;11(3). Epub 2022 Jun 21.

Department of Nuclear Medicine and Thyroid Unit, François Baclesse Cancer Centre, Caen, France.

Objective: 18F-Fluorocholine (18FCH) PET/CT has high sensitivity for parathyroid adenoma detection and can reliably exclude malignancy in thyroid nodules with indeterminate cytology. Data regarding 18FCH uptake in chronic autoimmune thyroiditis (CAT) are scarce. We aimed to assess thyroid 18FCH uptake in CAT with biological and histological correlation. Read More

Eur J Hybrid Imaging 2022 May 17;6(1):10. Epub 2022 May 17.

Department of Surgery, Flevoziekenhuis, Almere, The Netherlands.

Surgical excision of a parathyroid adenoma (PTA) is the only curative treatment for primary hyperparathyroidism (PHP). The transition from routine bilateral neck exploration to minimally invasive parathyroidectomy has been made possible by preoperative location techniques, including molecular imaging. Here, we present a case of a 76-year-old man with PHP who underwent a [F]fluorocholine PET/CT scan, which showed a rare undescended PTA at the level of the right carotid bifurcation. Read More

Calcif Tissue Int 2022 May 14. Epub 2022 May 14.

Department of Endocrinology, Seth GS Medical College and KEM Hospital, Parel, Mumbai, 400012, India.

Childhood and adolescent primary hyperparathyroidism (PHPT) is a very rare disease. Data on its molecular genetics are scarce. We performed a retrospective analysis (January 2000-January 2021) to determine the deleterious germline variants and genotype-phenotype correlations in children and adolescents < 20 years diagnosed with PHPT from a single referral center. Read More

Neuroimaging Clin N Am 2022 May;32(2):413-431

Department of Radiology, Wake Forest School of Medicine, Medical Center Boulevard, Winston Salem, NC 27157, USA.

Parathyroid imaging is predominantly used for preoperative localization of parathyroid lesions in patients with the biochemical diagnosis of primary hyperparathyroidism. Although imaging algorithms vary, in the era of minimally invasive parathyroidectomy for single parathyroid adenomas, multiphase parathyroid computed tomography (CT) (4-dimensional CT) has emerged as a favored modality for presurgical mapping of parathyroid lesions. Implementation and correct interpretation of these studies can be challenging, although confidence and accuracy improve with experience and volume. Read More

J Clin Ultrasound 2022 05;50(4):547-548

Department of Endocrinology, Kutahya Health Science University, School of Medicine, Kutahya, Turkey.

Sci Rep 2022 04 29;12(1):7058. Epub 2022 Apr 29.

Department of Internal Medicine, Endocrine Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.

Preoperative localisation studies are essential for parathyroidectomy in patients with primary hyperparathyroidism. If the location of abnormal parathyroid glands cannot be identified through non-invasive studies, parathyroid venous sampling (PVS) may be employed. In this study, we evaluated the utility of preoperative PVS in parathyroid surgery. Read More

Cancers (Basel) 2022 Apr 17;14(8). Epub 2022 Apr 17.

Service de Chirurgie Endocrinienne, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, 69495 Pierre-Bénite, France.

This large, retrospective, single-centre study evaluated the diagnostic performance of F-choline positron emission tomography/contrast-enhanced computed tomography (PET/ceCT) in preoperative parathyroid adenoma detection in primary hyperparathyroidism cases after negative/inconclusive ultrasound or other imaging findings. We included patients who underwent surgery and F-choline PET/ceCT for inconclusive imaging results between 2015 and 2020. We compared the F-choline PET/ceCT results with surgical and histopathological findings and identified the variables influencing the correlation between F-choline PET/ceCT and surgical findings. Read More

SAGE Open Med Case Rep 2022 11;10:2050313X221089759. Epub 2022 Apr 11.

Endocrine Unit, Faculty of Medicine, University Technology MARA, Jalan Hospital, Sungai Buloh, Selangor.

A 48-year-old female with long-standing type 2 diabetes mellitus presented with acute onset of bilateral lower limb weakness. She had been previously well and denied any constitutional symptoms. Physical examinations revealed generalized lower limb weakness with bilateral lower limb hypotonia, power of 0 over 5, reduced deep tendon reflexes, and loss of peripheral sensations up to the level of T10. Read More

Radiographics 2022 May-Jun;42(3):841-860. Epub 2022 Apr 15.

From the Department of Radiology (M.N., S.R.K., A.A., J.E.J., C.J.H., T.D.B.) and Department of Endocrine and Thyroid Surgery (F.P.), Imperial College Healthcare NHS Trust, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, England; Department of Radiology, Dartford and Gravesham NHS Trust, Kent, England (D.O.); and Department of Surgery and Cancer, Imperial College London, London, England (T.D.B.).

Primary hyperparathyroidism (PHPT) is a disorder characterized by hypercalcemia and an elevated or inappropriately normal parathyroid hormone level. Classic features include bone pain, fractures, renal impairment, nephrolithiasis, and mental disturbance. However, most cases of PHPT are now asymptomatic at diagnosis or associated with nonspecific neurocognitive changes. Read More

J Med Case Rep 2022 Apr 13;16(1):150. Epub 2022 Apr 13.

Department of Surgery, Urmia University of Medical Sciences, Urmia, Iran.

Background: Giant parathyroid adenoma is a type of parathyroid adenoma weighing > 3.5 g and having a size of more than 2 cm.

Case Presentation: This report describes giant primary parathyroid adenoma with reference to the literature. Read More

World J Surg 2022 Aug 11;46(8):1908-1914. Epub 2022 Apr 11.

Hadassah Hebrew-University School of Medicine, Jerusalem, Israel.

Background: Intraoperative PTH (ioPTH) monitoring has become widely accepted in the era of minimally invasive parathyroidectomy (MIP). The purpose of this study was to evaluate the need for ioPTH during parathyroidectomy in patients with positive preoperative imaging.

Methods: The charts of patients who underwent parathyroidectomy at three tertiary centers between the years 2012 and 2021 were retrospectively reviewed. Read More

Clin Radiol 2022 06 4;77(6):e401-e416. Epub 2022 Apr 4.

Department of Clinical Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK; Department of Nuclear Medicine, Leeds Teaching Hospitals NHS Trust, Leeds, UK. Electronic address:

Institutional variations in parathyroid adenoma localisation are largely dictated by local experience and availability of imaging investigations, with no consensus on the optimal approach. This review evaluates the role of multiple imaging techniques in primary hyperparathyroidism and highlights their advantages and limitations in different clinical contexts. A clinico-radiological review of parathyroid imaging techniques is illustrated with example cases and data from the literature. Read More

BMC Musculoskelet Disord 2022 Apr 4;23(1):322. Epub 2022 Apr 4.

Department of Orthopedic Surgery, Jingzhou Central Hospital, The Second Clinical Medical College of Yangtze University, No. 26, Chuyuan Ave, Jingzhou District, Jingzhou, Hubei, 434020, People's Republic of China.

Background: Osteitis fibrosa cystica is a rare, benign and osteolytic lesion attributed to hyperparathyroidism. The high level of parathyroid hormone cause rapid bone loss.

Case Presentation: The patient is a 50-year-old male complaining of severe and persistent pain in the right knee joint. Read More

Endocr Pract 2022 Apr 1. Epub 2022 Apr 1.

Department of Surgery, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, New York.

Objective: We studied the use of surgeon-performed office ultrasound (OU) and preincision ultrasound (PIU) in preoperatively localizing parathyroid adenomas in primary hyperparathyroidism (PHPT).

Methods: A retrospective chart review was performed for patients with PHPT who underwent parathyroidectomy between 2013 and 2015. The results of OU and PIU were recorded and compared with the final surgical pathology. Read More

Front Endocrinol (Lausanne) 2022 8;13:802453. Epub 2022 Mar 8.

Division of Endocrinology, Tongji Hospital, Huazhong University of Science & Technology, Wuhan, China.

Background: Multiple endocrine neoplasia type 1 (MEN1) is a hereditary endocrine syndrome caused by mutations in MEN1 tumor suppressor gene.

Case Presentation: A 53-year-old Chinese female was admitted to Division of Endocrinology, Tongji Hospital, for hypercalcemic crisis. Increased level of parathyroid hormone (PTH) was confirmed by laboratory tests, and imaging examination showed multiple parathyroid adenomas. Read More

Endocrine 2022 05 1;76(2):499-500. Epub 2022 Apr 1.

Thyroid Committee, European Association of Nuclear Medicine, Vienna, Austria.

J Ultrasound Med 2022 Mar 31. Epub 2022 Mar 31.

Department of Otolaryngology Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.

Objectives: Preoperative localization of pathological parathyroid glands with imaging is essential for focused unilateral neck exploration and minimally invasive techniques. Recently published studies suggested that contrast enhanced ultrasonography (CEUS) had high accuracy in the localization of hyperfunctioning parathyroid glands, with a general increase in the sensitivity as compared to conventional sonography. The purpose of this study was to determine the usefulness of CEUS in the localization of parathyroid lesions relating to surgical and histopathological data, in comparison to color Doppler ultrasound (CDUS), in the same series of patients. Read More

Acta Endocrinol (Buchar) 2021 Jul-Sep;17(3):393-398

"Sf. Spiridon" County Emergency Hospital - Nuclear Medicine Laboratory.

A 62 years old woman was diagnosed with multinodular toxic goiter and primary hyperparathyroidism/left parathyroid adenoma by hormonal assessment, ultrasound and nuclear thyroid/parathyroid scans. Cervical ultrasound illustrated a multinodular aspect of the thyroid with solid nodules and cystic-component nodules; the larger one represented a multinodular complex with necrosis areas in the left thyroid lobe, ACR TI-RADS score 4 (moderately suspicious). Functional nuclear imaging was performed for accurate differential diagnosis between thyroid . Read More

Am Surg 2022 Jul 25;88(7):1549-1550. Epub 2022 Mar 25.

Department of Surgery, 12320University of Puerto Rico, San Juan, Puerto Rico.

Parathyroidectomy is the only cure for primary hyperparathyroidism and is effective in more than 95% of cases at initial surgical intervention. However, 2.5-5% of cases have recurrent or persistent disease. Read More

Kidney Int 2022 04;101(4):834

Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia; Department of Renal Medicine, Westmead Hospital, Westmead, New South Wales, Australia.

BMC Endocr Disord 2022 Mar 16;22(1):68. Epub 2022 Mar 16.

Registrar in General Medicine, National Hospital of Sri Lanka, Ward 45/46, Colombo, Sri Lanka.

Background: Multiple endocrine neoplasia type 1 (MEN 1) syndrome is a rare, complex genetic disorder characterized by increased predisposition to tumorigenesis in multiple endocrine and non-endocrine tissues. Diagnosis and management of MEN 1 syndrome is challenging due to its vast heterogeneity in clinical presentation.

Case Presentation: A 23-year-old female, previously diagnosed with Polycystic Ovarian Syndrome (PCOS) and pituitary microprolactinoma presented with drowsiness,confusion and profuse sweating developing over a period of one day. Read More