The Infona portal uses cookies, i.e. strings of text saved by a browser on the user's device. The portal can access those files and use them to remember the user's data, such as their chosen settings (screen view, interface language, etc.), or their login data. By using the Infona portal the user accepts automatic saving and using this information for portal operation purposes. More information on the subject can be found in the Privacy Policy and Terms of Service. By closing this window the user confirms that they have read the information on cookie usage, and they accept the privacy policy and the way cookies are used by the portal. You can change the cookie settings in your browser.
Primary hyperparathyroidism is caused by single gland disease in 85% of cases and by multiglandular disease in 15%. Our aim was to discover if the addition of computed tomography acquisition/fusion on a hybrid scanner to traditional dual-phase single-photon emission tomography improves localization accuracy.A prospective database was queried for the perioperative data of patients with sporadic primary...
Recent guidelines from the American Thyroid Association recommend thyroid lobectomy for intrathyroidal differentiated thyroid cancers <4 cm. Our aim was to examine histology from patients with cytologic results that were positive or suspicious for malignancy to assess the extent of initial thyroidectomy based on criteria from the 2015 American Thyroid Association guidelines.We studied consecutive...
Preoperative detection of RAS mutations can contribute to cancer risk assessment in indeterminate thyroid nodules, although RAS is not always associated with malignancy.Fine-needle aspiration samples classified in 1 of 3 indeterminate cytology categories were prospectively tested for N-, H-, and K-RAS mutations using next-generation sequencing assay.In the study, 93 patients with 94 nodules had preoperative...
Primary hyperparathyroidism is rare in pediatric patients. Our study aim was to compare primary hyperparathyroidism in pediatric (<19 years) and young adult (19–29 years) patients.A prospectively collected database from a single, high-volume institution was queried for all patients age <30 years who had initial parathyroidectomy for primary hyperparathyroidism yielding 126/4,546 (2.7%) primary...
Erectile dysfunction (ED) is a common diagnosis associated with age, hypertension, cardiovascular disease, and diabetes. Primary hyperparathyroidism (PHP) is also seen with these comorbidities, but its association with ED has yet to be studied. We evaluated the rate and resolution of impotence after curative surgery for PHP.Prospectively collected data, including a self-reported questionnaire of symptoms,...
The uncommon diagnosis of atypical parathyroid adenoma (APA) creates a clinical conundrum for surveillance. We evaluated a large series of APA to determine long-term outcomes.Prospectively collected data were retrieved for patients with a diagnosis of histologic APA defined by presence of ≥2 criteria: clinical/intraoperative adherence, fibrotic bands, trabecular growth, or mitotic rate of >1/10...
We aimed to determine influence of surgeon volume on (1) frequency of appropriate initial surgery for differentiated thyroid cancer (DTC) and (2) completeness of resection.We reviewed all initial thyroidectomies (Tx; lobectomy and total) performed in a health system during 2011; surgeons were grouped by number of Tx cases per year. For patients with histologic DTC ≥1 cm, surgeon volume was correlated...
Fibromyalgia (FM), an ill-defined symptom complex, is characterized by musculoskeletal pain, headache, depression, fatigue, and cognitive decline, symptoms also seen commonly in primary hyperparathyroidism (PHP). Prevalence of concurrent PHP and FM and response to parathyroidectomy (PTX) of those with both conditions are unknown.We reviewed prospective data of 4,000 patients with sporadic PHP who...
In thyroid nodule fine-needle aspiration (FNA) cytology, the atypia of undetermined significance or follicular lesion of undetermined significance (AUS/FLUS) category has a 5–15% malignancy risk that increases to 85–99% when mutation testing for BRAF, RAS, RET/PTC, or PAX8/PPARγ is positive. However, negative testing does not exclude malignancy. The study objective was to identify clinical and imaging...
The use of molecular markers for thyroid cancer diagnosis, prognosis, and surveillance have been an exciting area of study and change. Recent investigative focus on promising new markers will very likely lead to improvements in the diagnostic utility of fine needle aspiration biopsy (FNAB) in predicting malignancy, as well as provide more accurate prognostic information pre- and postoperatively. The...
Although parathyroidectomy (Ptx) for sporadic primary hyperparathyroidism (PH) improves comorbidities and symptoms, routine Ptx for minimally symptomatic PH remains controversial. Whether successful Ptx translates into discontinuation or dose-reduction of prescribed medications is unknown.Consecutive patients undergoing curative Ptx for sporadic PH from January 2007 to April 2009 were compared to...
In multiple endocrine neoplasia type I and renal failure, the type of initial parathyroidectomy for hyperparathyroidism may influence the operative risks and development of recurrence. We compared subtotal parathyroidectomy with total parathyroidectomy and immediate forearm autotransplantation (TPFA) in a large series with long-term follow-up.The data of patients treated from 1977 to 2009 by initial...
To date, a mutation of the BRAF oncogene is the most common genetic alteration found in papillary thyroid carcinoma (PTC) and is associated with extrathyroidal extension, lymph node metastasis, and tumor recurrence. It is not known whether pre-operative identification of BRAF mutations in cytologic specimens should alter surgical management.From 2006 to 2008, the clinical, cytologic, and pathologic...
In the evaluation of patients with primary hyperparathyroidism (PHP), specific query for a personal or family history of MEN1 (Hx) is recommended widely, but responses are rarely positiv. We instituted a 6-question panel (6Q) to routinely screen for MEN1 preoperatively.The clinical database entries of 939 patients explored for apparent sporadic PHP from June 1992 to November 2007 were examined for...
The histologic diagnosis of parathyroid carcinoma (PC) is challenging. We evaluated a large PC series for loss of heterozygosity (LOH) of selected tumor suppressor genes with histopathologic correlation.Among 2,238 patients explored for primary hyperparathyroidism (PHP), the cytoarchitectural parameters of 60 patients with surgical and/or pathologic suspicion for PC were examined by 1 pathologist...
Set the date range to filter the displayed results. You can set a starting date, ending date or both. You can enter the dates manually or choose them from the calendar.