Retropharyngeal ectopic parathyroid adenoma versus lymph node: Problem solving with CT neck angiogram

PP Batchala, PK RehmJournal of Postgraduate Medicine 2019 65(4):237-240 A 66-year-old female underwent preoperative evaluation for primary hyperparathyroidism. Ultrasound (US) neck and technetium (Tc)-99m-sestamibi planar scintigraphy were negative, but single photon emission computed tomography/computed tomography (SPECT/CT) demonstrated a tracer-avid retropharyngeal nodule compatible with parathyroid adenoma (PTA). A retrospective review of CT neck angiogram (CTA) and neck magnetic resonance imaging (MRI) performed 4 months earlier for stroke evaluation revealed arterial phase hyperenhancing retropharyngeal tissue, which had been dismissed as a nonpathological lymph node. “Polar vessel sign” seen in two-thirds of PTA was also present on retrospective review of the CTA. The concordant findings between SPECT/CT and CTA were indicative of a solitary undescended ectopic PTA in the retropharyngeal space, an uncommon location. A successful surgical cure was achieved after minimally invasive parathyroidectomy. This case highlights the retropharyngeal space as an important ectopic site of PTA, limitation of US, and Tc-99m-sestamibi planar scintigraphy in identifying retropharyngeal PTA. We also discuss the role of CT and MRI and the challenge in differentiating retropharyngeal PTA from a lymph node.
Source: Journal of Postgraduate Medicine - Category: Internal Medicine Authors: Source Type: research

Related Links:

CONCLUSION: The presence of vascular calcifications and arterial stiffness was highly prevalent in our population. We suggest that ABI, a simple and cost-effective diagnostic tool, could be used at an outpatient basis to predict cardiovascular events in patients with severe SHPT undergoing HD.PMID:33979425 | DOI:10.1590/2175-8239-JBN-2020-0218
Source: Jornal Brasileiro de Nefrologia - Category: Urology & Nephrology Authors: Source Type: research
Introduction: Hyperparathyroid crisis is a rare and potentially life-threatening complication of severe calcium intoxication. Parathyroidectomy is the only curative method for hyperparathyroid crisis. Several case reports and case series have been published on the medical and surgical treatments for hyperparathyroid crisis, however, few reports have focused on the associated perioperative anesthetic management. Patient concerns: A 48-year-old Chinese woman presented with a 2-week history of nausea and vomiting and complained of mental status alteration including confusion and agitation in the 24 hours prior to...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
CONCLUSIONS: Bisphosphonate therapy may reduce fracture and bone pain after kidney transplantation, however low certainty in the evidence indicates it is possible that treatment may make little or no difference. It is uncertain whether bisphosphonate therapy or other bone treatments prevent other skeletal complications after kidney transplantation, including spinal deformity or avascular bone necrosis. The effects of bone treatment for children and adolescents after kidney transplantation are very uncertain. PMID: 31637698 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
When counseling patients regarding the potential benefits of parathyroidectomy for primary hyperparathyroidism (PHPT), surgeons discuss the possible short-term and long-term consequences of operation. The short-term benefits may include alleviation of fatigue, bone aches, depressed mood, and frequent urination. While it is extremely rewarding to improve these symptoms, it is the long-term benefits that may be truly life-altering and potentially lifesaving. The organs most likely to be negatively affected by PHPT are the bones, kidneys, brain, and heart. Medical students everywhere still learn about the effects of this dise...
Source: JAMA Surgery - Category: Sports Medicine Source Type: research
ConclusionMediacalcosis is a severe complication since it increases the risk of cardiovascular morbidity and mortality in hemodialysis patients, to this end, the individualization of entangled factors involved in its pathophysiology, will slow down or prevent its progression in the future.
Source: Archives of Cardiovascular Diseases Supplements - Category: Cardiology Source Type: research
Publication date: Available online 24 July 2019Source: Archives of Cardiovascular Diseases SupplementsAuthor(s): Djamila-Djahida Batouche, Kheireddine Kerboua, Nadia-Faiza benatta, Samia Benouaz, Rabia Okbani, Wahiba Berrachdi, Miloud Lahmer, Lynda Sadaoui, Fadela Benhamed, Z. MentouriObjectivesCardiovascular complications are the leading cause of death and morbidity in chronic hemodialysis patients. The purpose of this study was to identify the factors associated with major cardiovascular events in hemodialysis children.MethodsBi-centric study was carried out during in 2016 into two hemodialysis departments. We included h...
Source: Archives of Cardiovascular Diseases Supplements - Category: Cardiology Source Type: research
Authors: Wajda J, Świat M, Owczarek AJ, Brzozowska A, Olszanecka-Glinianowicz M, Chudek J Abstract Background: Vitamin D (VD) deficiency is considered an independent risk factor for death due to cardiovascular events including ischemic stroke (IS). We assessed the hypothesis that decreased levels of 25-hydroxyvitamin D (25-OH-D) are associated with increased risk of mortality in patients with IS. Methods: Serum 25-OH-D, intact parathyroid hormone (iPTH), and intact fibroblast growth factor 23 (iFGF23) levels were assessed in serum of 240 consecutive patients admitted within the 24 hours after the onset of IS. ...
Source: Disease Markers - Category: Laboratory Medicine Tags: Dis Markers Source Type: research
Fight Aging! provides a weekly digest of news and commentary for thousands of subscribers interested in the latest longevity science: progress towards the medical control of aging in order to prevent age-related frailty, suffering, and disease, as well as improvements in the present understanding of what works and what doesn't work when it comes to extending healthy life. Expect to see summaries of recent advances in medical research, news from the scientific community, advocacy and fundraising initiatives to help speed work on the repair and reversal of aging, links to online resources, and much more. This content is...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Ryan R. Kelly1,2†, Lindsay T. McDonald1,2†, Nathaniel R. Jensen1,2, Sara J. Sidles1,2 and Amanda C. LaRue1,2* 1Research Services, Ralph H. Johnson VA Medical Center, Charleston, SC, United States 2Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, United States The significant biochemical and physiological effects of psychological stress are beginning to be recognized as exacerbating common diseases, including osteoporosis. This review discusses the current evidence for psychological stress-associated mental health disorders as risk factors for os...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
CONCLUSIONS: We found no evidence linking TMAO to adverse clinical outcomes in patients receiving maintenance hemodialysis with moderate to severe secondary hyperparathyroidism. PMID: 30665924 [PubMed - as supplied by publisher]
Source: Clinical Journal of the American Society of Nephrology : CJASN - Category: Urology & Nephrology Authors: Tags: Clin J Am Soc Nephrol Source Type: research
More News: Angiography | CT Scan | Hyperparathyroidism | Internal Medicine | MRI Scan | Parathyroidectomy | SPECT | Stroke | Ultrasound