- Preoperative Localization and Intraoperative Parathyroid Hormone Assay in Korean Patients with Primary Hyperparathyroidism
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Eirie Cho, Jung Mi Chang, Seok Young Yoon, Gil Tae Lee, Yun Hyi Ku, Hong Il Kim, Myung-Chul Lee, Guk Haeng Lee, Min Joo Kim
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Endocrinol Metab. 2014;29(4):464-469. Published online December 29, 2014
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DOI: https://doi.org/10.3803/EnM.2014.29.4.464
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- Background
The intraoperative parathyroid hormone (IOPTH) assay is widely used in patients with primary hyperparathyroidism (PHPT). We investigated the usefulness of the IOPTH assay in Korean patients with PHPT. MethodsWe retrospectively reviewed the data of 33 patients with PHPT who underwent parathyroidectomy. Neck ultrasonography (US) and 99mTc-sestamibi scintigraphy (MIBI scan) were performed preoperatively and IOPTH assays were conducted. ResultsThe sensitivity of neck US and MIBI scans were 91% and 94%, respectively. A 50% decrease in parathyroid hormone (PTH) levels 10 minutes after excision of the parathyroid gland was obtained in 91% (30/33) of patients and operative success was achieved in 97% (32/33) of patients. The IOPTH assay was 91% true-positive, 3% true-negative, 0% false-positive, and 6% false-negative. The overall accuracy of the IOPTH assay was 94%. In five cases with discordant neck US and MIBI scan results, a sufficient decrease in IOPTH levels helped the surgeon confirm the complete excision of the parathyroid gland with no additional neck exploration. ConclusionThe IOPTH assay is an accurate tool for localizing hyperfunctioning parathyroid glands and is helpful for evaluating cases with discordant neck US and MIBI scan results.
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Citations
Citations to this article as recorded by
- Single-Center Experience of Parathyroidectomy Using Intraoperative Parathyroid Hormone Monitoring
Seong Hoon Kim, Si Yeon Lee, Eun Ah Min, Young Mi Hwang, Yun Suk Choi, Jin Wook Yi Medicina.2022; 58(10): 1464. CrossRef - The natural history and hip geometric changes of primary hyperparathyroidism without parathyroid surgery
Kyong Yeun Jung, A. Ram Hong, Dong Hwa Lee, Jung Hee Kim, Kyoung Min Kim, Chan Soo Shin, Seong Yeon Kim, Sang Wan Kim Journal of Bone and Mineral Metabolism.2017; 35(3): 278. CrossRef - The utility of the radionuclide probe in parathyroidectomy for primary hyperparathyroidism
MS Lim, M Jinih, CH Ngai, NM Foley, HP Redmond The Annals of The Royal College of Surgeons of England.2017; 99(5): 369. CrossRef - Articles in 'Endocrinology and Metabolism' in 2014
Won-Young Lee Endocrinology and Metabolism.2015; 30(1): 47. CrossRef
- Thyroid
- Medullary Thyroid Carcinoma with Ectopic Adrenocorticotropic Hormone Syndrome
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Hong Seok Choi, Min Joo Kim, Chae Ho Moon, Jong Ho Yoon, Ha Ra Ku, Geon Wook Kang, Im Il Na, Seung-Sook Lee, Byung-Chul Lee, Young Joo Park, Hong Il Kim, Yun Hyi Ku
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Endocrinol Metab. 2014;29(1):96-100. Published online March 14, 2014
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DOI: https://doi.org/10.3803/EnM.2014.29.1.96
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4,221
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Ectopic adrenocorticotropic hormone (ACTH) syndrome is caused most frequently by a bronchial carcinoid tumor or by small cell lung cancer. Medullary thyroid carcinoma (MTC) is a rare etiology of ectopic ACTH syndrome. We describe a case of Cushing syndrome due to ectopic ACTH production from MTC in a 48-year-old male. He was diagnosed with MTC 14 years ago and underwent total thyroidectomy, cervical lymph node dissection and a series of metastasectomies. MTC was confirmed by the pathological examination of the thyroid and metastatic mediastinal lymph node tissues. Two years after his last surgery, he developed Cushingoid features, such as moon face and central obesity, accompanied by uncontrolled hypertension and new-onset diabetes. The laboratory results were compatible with ectopic ACTH syndrome. A bilateral adrenalectomy improved the clinical and laboratory findings that were associated with Cushing syndrome. This is the first confirmed case of ectopic ACTH syndrome caused by MTC in Korea.
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Citations
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- Medullary thyroid carcinoma with ACHT-dependent Cushing's syndrome: Therapeutic possibilities
Dušan Ilić, Sanja Ognjanović, Bojana Popović, Valentina Elezović-Kovačević, Milica Opalić-Palibrk, Lena Radić, Katarina Krstić, Đuro Macut Medicinski glasnik Specijalne bolnice za bolesti štitaste žlezde i bolesti metabolizma.2024; 29(93): 46. CrossRef - Medullary Thyroid Cancer with Ectopic Cushing's Syndrome: A Case Report and Systematic Review of Detailed Cases from the Literature
Andrea Corsello, Vittoria Ramunno, Pietro Locantore, Giovanni Pacini, Esther Diana Rossi, Francesco Torino, Alfredo Pontecorvi, Carmela De Crea, Rosa Maria Paragliola, Marco Raffaelli, Salvatore Maria Corsello Thyroid.2022; 32(11): 1281. CrossRef - Mucosal Neuroma Cues for Endocrine Emergency Treatment
Gyu Gang Choi, Hwan Jin Lee, Hyo Jin Han, Young Beom Jeong, Heung Bum Lee, Ji Hyun Park Endocrinology and Metabolism.2021; 36(6): 1312. CrossRef - Articles in 'Endocrinology and Metabolism' in 2014
Won-Young Lee Endocrinology and Metabolism.2015; 30(1): 47. CrossRef - Rapid response of hypercortisolism to vandetanib treatment in a patient with advanced medullary thyroid cancer and ectopic Cushing syndrome
Fabián Pitoia, Fernanda Bueno, Angélica Schmidt, Sabrina Lucas, Graciela Cross Archives of Endocrinology and Metabolism.2015; 59(4): 343. CrossRef
- A case of Paraganglioma Arising in the Transverse Mesocolon.
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Hong Il Kim, Bo kyung Koo, You Jin Lee, Jin Taek Kim, Young Min Cho, Kuhn Uk Lee, Seong Yeon Kim
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J Korean Endocr Soc. 2005;20(5):496-501. Published online October 1, 2005
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DOI: https://doi.org/10.3803/jkes.2005.20.5.496
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1,881
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- Herein, a case of a solitary primary paraganglioma arising in the mesentery, found in a hypertensive 70-year-old woman, who presented with nausea and postprandial abdominal discomfort, is reported. Ultrasonography and computed tomography showed a hypervascular mass abutting the second portion of the duodenum. An exploratory laparotomy revealed a 5.5 x 5.3 x 5cm sized mass in the mesentery of the transverse colon, which was histologically proven to be a paraganglioma. No intraoperative hemodynamic changes developed, and the postoperative course was uneventful. To our knowledge, this is the first case of a paraganglioma arising in the mesentery reported in Korea. Considering the unusual locations and the associated operative risk, it is necessary to rule out the possibility of a functioning paraganglioma in the preoperative differential diagnosis of an abdominal mass.
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Citations
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- Mesenteric Lesions with Similar or Distinctive Appearances on CT
Hwajin Cha, Jiyoung Hwang, Seong Sook Hong, Eun Ji Lee, Hyun-joo Kim, Yun-Woo Chang Journal of the Korean Society of Radiology.2019; 80(6): 1091. CrossRef
- A Case of Protein-losing Enteropathy with an Abnormal Cortisol Response to ACTH Stimulation.
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Hong Il Kim, Bo Kyeong Koo, You Jin Lee, Eun Jung Lee, Soo Heon Kwak, Sun Wook Cho, Hyung Jin Choi, Young Min Cho, Seong Yeon Kim
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J Korean Endocr Soc. 2005;20(1):90-95. Published online February 1, 2005
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DOI: https://doi.org/10.3803/jkes.2005.20.1.90
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- We hereby report a case of a 62-year-old male patient who was misdiagnosed with adrenal insufficiency during the course of protein-losing enteropathy caused by superior mesenteric arterial thrombosis. The patient was suspected to have adrenal insufficiency due to hyponatremia and severe weakness. The cortisol responses to the initial challenge of 250microgram ACTH were inadequate (maximum serum cortisol level after ACTH challenge was 10.9microgram/dL), while the serum albumin concentration was 1.9g/dL. Subsequently, intravenous steroid therapy was given to the patient. However, after bowel resection, the serum albumin level increased to 3.4g/dL and the cortisol response to the follow-up rapid ACTH stimulation was completely normal. Accordingly, we discontinued steroid replacement and discharged the patient without any problem. In conclusion, measuring total serum cortisol in a patient with hypo-pro-teinemia may lead to misdiagnosis of adrenal insufficiency. In such cases, caution should be exercised in interpreting the results in terms of total serum cortisol level or measurement of serum free cortisol levels should be considered.
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