Spontaneous necrosis of parathyroid adenoma: biochemical and imaging follow-up for two years

SummaryWereport a patient with a biochemically and radiologically confirmed parathyroid adenoma, which underwent spontaneous resolution by necrosis. The patient was followed-up over the subsequent two years during which time the tumour and hypercalcaemia recurred. Sequential radiological and biochemical changes at the time of diagnosis, spontaneous necrosis and recurrence are documented fully. biochemical and changes following report a patient who spontaneous infarction of her parathyroid adenoma, while await-ing surgery, with detailed documentation of the above-mentioned features. SummaryWedescribe a patient with primary hypothyroidism due to autoimmune thyroiditis, presenting with acute myoedema and spontaneous rhabdomyolysis. During his hospital stay, he developed altered sensorium due to hypo-osmolal hyponatraemia and later developed bilateral foot drop that responded to appropriate treatment. We SummaryAyoung healthy man presented with abdominal pain following an accidental fall. Imaging studies and laparoscopy revealed multiple yellowish well-defined hepatic lesions. Liver biopsies showed hepatic adenomas and iron overload. Laboratory investigation confirmed a diagnosis of hereditary haemochromatosis. To our knowledge this represents the first report of an association of hepatic adenomatosis and primary haemochromatosis. SummaryApatientwith an aggressive intrasinusoidal non-Hodgkins lymphoma, presenting with marked systemic disturbance but only a mildly raised alkaline phosphatase as a localising sign is described. All imaging studies of the liver were normal and the diagnosis was delayed until a percutaneous liver biopsy was performed. Once diagnosed, the patient responded extremely well to conventional anti-lymphoma chemotherapy. Here we report the case of an aggressive intrasinusoidal lymphoma of the presenting as a with only a mildly raised alkaline phosphatase as an initial localising feature. Aspergillus is an opportunistic nosocomial fungus generally associated with a high mortality rate. A niger has been rarely associated with infection, and most cases have occurred in patients who have recently undergone heart surgery or in immunocompromised patients. We present a case of an immunocompetent patient with A niger endocarditis which illustrates the di Y culties in diagnosis and the possible insidious course of fungal endocarditis. neoplastic

[1]  C. Vivas,et al.  Endocarditis caused by Aspergillus niger: case report. , 1998, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[2]  G. Gores,et al.  Management of liver adenomatosis: results with a conservative surgical approach. , 1998, Liver transplantation and surgery : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society.

[3]  A. Proos,et al.  Hereditary Haemochromatosis , 1997 .

[4]  C. Cockram,et al.  Primary Hyperparathyroidism Complicated by Osteomalacia , 1996, Annals of clinical biochemistry.

[5]  K. Nakao,et al.  Spontaneous remission of primary hyperparathyroidism due to hemorrhagic infarction in the parathyroid adenoma. , 1996, Internal medicine.

[6]  E. Nylen,et al.  Spontaneous remission of primary hyperparathyroidism from parathyroid apoplexy. , 1996, The Journal of clinical endocrinology and metabolism.

[7]  L. Haddock,et al.  Unusual cases of hyperparathyroidism. , 1995, Puerto Rico Health Sciences Journal.

[8]  W. Vogel,et al.  A case of hepatocellular adenomatosis with a follow-up of 11 years. , 1995, American Journal of Gastroenterology.

[9]  G. Cornel,et al.  Liposomal amphotericin B for postoperative Aspergillus fumigatus endocarditis. , 1995, The Annals of thoracic surgery.

[10]  Samruay Shuangshoti,et al.  Hepatocellular adenoma in a beta-thalassemic woman having secondary iron overload. , 1994, Journal of the Medical Association of Thailand = Chotmaihet thangphaet.

[11]  T. Gerold,et al.  Spontaneous infarction of parathyroid adenoma: Case report and literature review , 1993, Head & neck.

[12]  V. Andriole Infections with Aspergillus species. , 1993, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[13]  K. Aozasa,et al.  Primary malignant lymphoma of the liver. , 1993, Leukemia & lymphoma.

[14]  P. Anthony,et al.  Primary lymphoma of the liver: clinical and pathological features of 10 patients. , 1990, Journal of clinical pathology.

[15]  D. Denning,et al.  Antifungal and surgical treatment of invasive aspergillosis: review of 2,121 published cases. , 1990, Reviews of infectious diseases.

[16]  J. Barzilay,et al.  Spontaneous hematoma of a parathyroid adenoma. , 1989, The American journal of the medical sciences.

[17]  L. Loeb,et al.  Mutagenesis by the autoxidation of iron with isolated DNA. , 1988, Proceedings of the National Academy of Sciences of the United States of America.

[18]  J. Boitnott,et al.  Primary lymphomas of the liver. Report of six cases and review of the literature. , 1987, American journal of clinical pathology.

[19]  B. Osborne,et al.  Primary lymphoma of the liver ten cases and a review of the literature , 1985, Cancer.

[20]  C. Degott,et al.  Liver adenomatosis. An entity distinct from liver adenoma? , 1985, Gastroenterology.

[21]  J. Farndon,et al.  Selective Arteriography Causing Infarction of a Parathyroid Adenoma , 1982, Journal of the Royal Society of Medicine.

[22]  K. Ishak,et al.  Hepatocellular adenoma in a young woman with beta-thalassemia and secondary iron overload. , 1981, Gastroenterology.

[23]  I. Fogelman,et al.  Autoparathyroidectomy: A case report , 1979, The British journal of surgery.

[24]  G. Mark,et al.  Multiple hepatic adenomas and a hepatocellular carcinoma in a man on oral methyl testosterone for eleven years , 1977, Cancer.

[25]  P. Carpenter,et al.  Mediastinal hemorrhage from parathyroid adenoma simulating dissecting aneurysm. , 1974, Archives of surgery.

[26]  R. Northcutt,et al.  Hypocalcemia resulting from infarction of a parathyroid adenoma. , 1969, Annals of internal medicine.

[27]  A. R. Muir,et al.  Hepatic pathology in relatives of patients with haemochromatosis. , 1962, The Journal of pathology and bacteriology.

[28]  H. Dowlatabadi Acute fatal parathyroid poisoning associated with necrosis of the parathyroid adenoma prior to death. , 1959, The Journal of clinical endocrinology and metabolism.

[29]  T. Connor,et al.  Hyperparathyroidism; case report illustrating spontaneous remission due to necrosis of adenoma, and a study of the incidence of necroses in parathyroid adenomas. , 1953, The Journal of clinical endocrinology and metabolism.

[30]  T. M. Arsenault,et al.  Hepatic adenomatosis. , 1996, Mayo Clinic proceedings.

[31]  Michael Zimpfer,et al.  Transesophageal Echocardiography , 1995, Springer Vienna.

[32]  G. Stavridis,et al.  Aspergillus prosthetic valve endocarditis. , 1993, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[33]  N. Thompson,et al.  Spontaneous cervical hematoma: a rare manifestation of parathyroid adenoma. , 1981, Surgery.

[34]  F. Kuhlencordt,et al.  [Primary hyperparathyroidism]. , 1979, Deutsche medizinische Wochenschrift.

[35]  T. Connor,et al.  Intermittent hyperparathyroidism. , 1966, Transactions of the American Clinical and Climatological Association.

[36]  Philip James Johnson,et al.  Aggressive primary hepatic lymphoma in chinese patients. Presentation, pathologic features, and outcome , 2022 .