• 대한영상의학회지
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• 제85권2호
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• pp.327-344
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• 2024

부갑상선은 부갑상선 호르몬(parathyroid hormone; 이하 PTH)을 생성하여 칼슘 대사를 조절하는 작은 내분비선으로 구성되어 있다. 일반적으로 갑상선 뒤에 4개의 부갑상선이 위치해 있으나 개수 또는 위치는 개인차가 있으며 4개보다 많거나 적은 경우들이 있다. 부갑상선 질환은 부갑상선 기능 장애와 관련이 있으며, 부갑상선 자체의 문제 또는 신장질환으로 인한 비정상적인 혈청 칼슘 수치로 인해 발생할 수 있다. 최근 건강검진이 보편화되면서 우연히 비정상적으로 높은 혈청 칼슘 값이 발견되어 PTH 검사, 초음파, 테크네튬-99m 세스타 미비 부갑상선 스캔, 단일광자방출단층촬영/컴퓨터단층촬영(SPECT/CT), 4차원 컴퓨터단층촬영(4D-CT), 그리고 양전자방출단층촬영/컴퓨터단층촬영(PET/CT) 등의 추가적인 검사가 시행된다. 그러나 부갑상선은 여전히 영상의학과 의사에게 익숙하지 않은 기관이다. 이 종설에서 부갑상선의 해부학, 병태생리, 영상 및 임상 소견에 대해 알아보고자 한다.

• 대한두경부종양학회지
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• 제23권2호
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• pp.165-169
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• 2007

Parathyroid gland tumor is an uncommon disease. The symptoms of parathyroid gland tumor appear in various features such as general weakness, renal stones, bone diseases and malignancies in some cases. We summarized the clinical features of 6 cases of parathyroid gland tumors with literatures.

• 대한두경부종양학회지
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• 제34권1호
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• pp.29-32
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• 2018

The parathyroid glands are usually located in the posterolateral area of the thyroid gland. Due to their embryologic origin, they are sometimes found in an ectopic position from the angle of the jaw to the mediastinum. However, their incidental detection in the hypopharyngeal wall is rare. Herein, we report a case of an ectopic parathyroid gland found in the hypopharyngeal wall of a 39-year old woman with no known endocrine abnormality.

• Journal of Endocrine Surgery
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• 제18권4호
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• pp.236-239
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• 2018

Secondary hyperparathyroidism (SHPTH) occurs commonly in patients with end-stage renal disease (ESRD). Uncontrolled SHPTH is associated with complications of calcium deposition including calciphylaxis and elevated rates of cardiovascular morbidity. Current treatment recommendations for medically refractory disease include total parathyroidectomy, often with autotransplantation (TPTH+AT) of minced parathyroid gland. Surgical intervention is associated with a reduction in cardiovascular mortality. We report a case of a 56-year-old man with ESRD who developed SHPTH and underwent TPTH+AT of parathyroid tissue into the right brachioradialis muscle. Over the course of 7 years he developed a mass at the site of the autotransplanted gland as well as recurrent refractory hyperparathyroidism with increased forearm uptake noted on sestamibi scan. After excision of this mass, pathology demonstrated hyperplasia of the minced gland fragments which were embedded within a mass of fibroadipose tissue rather than the muscle tissue it was originally transplanted in.

• Journal of Yeungnam Medical Science
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• 제27권2호
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• pp.139-145
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• 2010

Cystic parathyroid adenoma is one of rare causes of hyperparathyroidism, and tends to cause increased serum level of parathyroid hormone, alkaline phosphate and serum calcium level similar to when compared to those of solid adenoma. The possibility of a coincidental appearance of primary hyperparathyrodism and nonmedullary thyroid cancer is rare, and often neglected. A 40-year-old female presented with constipation and weight loss for 3 months. The serum calcium, phosphate and alkaline phosphate were 16.6 mg/dl, 2.2 mg/dl and 505 IU/L respectively and serum parathyroid hormone level was 1556.2 pg/mL. Neck US showed mixed nodules at both thyroid lobes, and PET-CT showed a right thyroid nodule without FDG uptake. The patient was diagnosed of primary hyperparathyroidism and underwent parathyroidectomy and a total thyroidectomy. Histopathologic results revealed parathyroid adenoma with cystic change (2 cm greater diameter) in the right lower parathyroid gland and coexistent papillary carcinoma of the right lobe of thyroid gland (infiltrating, 0.3 cm in greater diameter). She remained well and serum calcium, phosphate, parathyroid hormone level were normalized within 24 hours.

• 대한두경부종양학회지
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• 제10권1호
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• pp.31-37
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• 1994

Primary hyperparathyroidism is rare disease entity which secretes parathyroid hormone in excessively resulting in hypercalcemia. It involves skeletal system, urinary tract, gastrointestinal tract, and central nervous system. Recently the determination of the serum calcium and parathyroid hormone level has become a routine laboratory test and the localization of involved gland by neck ultrasonogram and parathyroid gland substraction scan has reduced operative complications. For the purpose of improvement of diagnosis and treatment, the authors analyzed the clinical characteristics of 6 cases of primary hyperparathyroidism(adenoma 5 cases, carcinoma 1 case) during 10 years and report with literatures.

• 대한핵의학회지
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• 제37권4호
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• pp.260-261
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• 2003

Tc-99m methoxyisobutylisonitrile (MIBI) and Tl-201/technetium subtraction scintigraphy have been used for localization of abnormal parathyroid gland. The uptake mechanism of tracers has been postulated to be increased cellular density and vascularity, or dependent on the presence of mitochondria-rich cells. However, the uptake of these tracers was not specific for abnormal parathyroid gland. The author report a case of thymic carcinoma that would have been mistaken for carcinoma of parathyroid because of Tc-99m MIBI and Tl-201 uptake.

• Advances in pediatric surgery
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• 제6권1호
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• pp.68-69
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• 2000

A case of primary hyperparathyroidism due to parathyroid adenoma is presented. A 14 year-old male was admitted to the hospital comptaining of voiding difficulty. The intravenous pyelogram demonstrated a stone in the proximal one third of the left ureter and marked hydronephrosis of the left kidney. The Tc-99m sestamibi nuclear scan demonstrated a hot spot below the lower pole of the left lobe of the thyroid. Laboratory study demonstrated hypercalcemia (12.4 mg/dL) and elevated parathyroid hormone (143.67 pg/mL). A parathyroid gland located below the lower pole of the left lobe of the thyroid was excised. A parathyroid adenoma, consisting of mainly chief cells was found on pathologic examination. Postoperatively the patient had transient hypocalcemic symptoms, which resolved with administration of calcium preparation and vitamin D.

• 한국수의병리학회:학술대회논문집
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• 한국수의병리학회 2003년도 추계학술대회초록집
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• pp.35-38
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• 2003

The parathyroid gland is probably the simplest endocrine organ in the body. The only cells of clinical significance are the parathyroid or chief cells. The primary signal that these cells listen to is calcium. Primary hyperparathyroidism is due to a parathyroid adenoma. The most common cause of hypercalcemia in veterinary medicine is hypercalcemia of malignancy associated with variety of neoplasms. Secondary hyperparathyroidism is due to a disease process, most commonly associated with renal and nutritional hyperparathyroidism. Primary and secondary hyperparathyroidism are markedly different in their clinical, laboratory, and pathogenic mechanism.

• 대한두경부종양학회지
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• 제39권2호
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• pp.27-30
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• 2023

A 65-year-old patient who underwent total thyroidectomy 10 years ago was suspected of having a parathyroid adenoma, and minimally invasive parathyroidectomy was planned. Preoperative ultrasonography(USG) and 99mTc MIBI scan indicated a left lower parathyroid lesion. In the first operation, intraoperative parathyroid hormone monitoring (IOPTH) was not possible due to hospital circumstances. Although no adenomatous lesion was found in the expected surgical field, surgery was completed after removing lesions around the left lower parathyroid gland. However, post-surgery, parathyroid hormone did not decrease at all, so a second operation was performed with IOPTH preparation. In the second operation, intraoperative ultrasonography was performed, and a suspected adenoma lesion was removed from the left upper lesion. He has been under follow-up for 3 years without complications. Surgeon-peformed intraoperative USG and preoperative scintigraphy had advantages in determining the localization of parathyroid lesion even withiout IOPTH.