Defining the Thyroid-RLN Entry Triangle for Enhanced Recurrent Laryngeal Nerve Exposure in TOETVA: A Retrospective Study.

Background: Injury to the recurrent laryngeal nerve (RLN) and parathyroid glands (PGs) are the most common and serious complications during the transoral endoscopic thyroidectomy vestibular approach (TOETVA), and their exposure and protection are the most important factors affecting the operation time. Here, we report a novel anatomical landmark and surgical method to shorten the operative time and reduce the chance of injury to the RLN and PGs.

Methods: According to the different exposure methods of the RLN, patients were divided into the experimental group (from top to bottom, E-group) and the comparison group (from outside to inside, C-group), and 1:1 propensity score-matching (PSM) was performed.

Case report: Ectopic production of intact parathyroid hormone (iPTH) by malignoma mimicking primary hyperparathyroidism.

Background: Malignant hypercalcemia is usually caused by osteolytic processes of metastases, production of parathormone-related peptide, or secretion of 1,25-dihydroxyvitamin D. Ectopic PTH (parathyroid hormone) production by malignancy is very unusual.

Methods: Case report and review of the literature.

Primary tumor resection with or without neck lymph node dissection as a viable initial therapy for medullary thyroid carcinoma with distant metastasis.

Objective: Patients with distant metastatic medullary thyroid carcinoma (DMMTC) often undergo primary tumor resection (PTR) with or without neck lymph node dissection (NLND) before systemic therapy. However, whether these patients benefit from treatment remains unclear.

Methods: Patients with DMMTC were identified from the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2020.

Primary hyperparathyroidism due to a giant parathyroid adenoma presenting with pathological fractures and multiple brown tumors.

Summary: Primary hyperparathyroidism (PHPT) is a disorder in which excessive parathyroid hormone (PTH) is secreted from the parathyroid glands. The cause of PHPT is most commonly parathyroid lesions such as parathyroid adenoma. The clinical manifestations of PHPT include hypercalcemia, nephrolithiasis, bone disease and rarely pathological fractures and brown tumors, which arise within the foci of osteitis fibrosa.

A Positive Parathyroid Washout May Obviate the Need for Nuclear Scintigraphy in Parathyroid Adenoma Localization: A Retrospective Study.

Background: Minimally invasive parathyroidectomy (MIP) in patients with a parathyroid adenoma (PA) requires imaging modalities for precise localization. Parathyroid hormone assay on ultrasound-guided fine-needle aspiration washout, or PTH washout, can be used for this purpose. It is unclear whether PTH washout complements traditional PA localization techniques such as a sestamibi (MIBI) scan or diminishes its need.

Comparative effectiveness totally endoscopic thyroidectomy via completely submental tri-hole approach and transoral endoscopic thyroidectomy without insufflation.

Objective: This study aims to evaluate the therapeutic effectiveness of totally endoscopic thyroidectomy via the completely submental tri-hole approach and transoral endoscopic thyroidectomy without insufflation.

Methods: A total of 60 patients with thyroid tumors who were admitted to Panyu College Affiliated Hospital from August 2022 to August 2023 were collected in this study. The patients were divided into two groups, the transoral endoscopic thyroidectomy group (20 cases) and the totally endoscopic thyroidectomy via the completely submental tri-hole approach group (40 cases).

Somatostatin Receptor Imaging in the Diagnosis and Management of Parathyroid Neuroendocrine Neoplasia.

Background: Parathyroid tumors are classified as parathyroid neuroendocrine neoplasia (NEN) by the IARC-WHO classification. These tumors can occur with NENs from other sites, which often require total-body [68Ga]-DOTA-peptides PET/CT. This study aimed to assess the utility of [68Ga]-DOTA-peptide PET/CT in imaging parathyroid NENs and to evaluate the underlying mechanisms.

Navigating diagnostic dilemmas: Localizing parathyroid adenoma in the presence of MIBI-avid thyroid nodules: A case report and literature review.

Surgery is the preferred treatment for primary hyperparathyroidism (PHPT), but the presence of MIBI-avid thyroid nodules can complicate the localization of parathyroid adenoma (PA). In this case report, we discuss the role of imaging in localizing PA in a patient with concurrent thyroid nodules. A 49-year-old female presented with hypercalcemia and elevated parathyroid hormone levels.

c.1155-3A>G is a pathogenic variant that causes aberrant splicing, disrupted parafibromin expression, and hyperparathyroidism-jaw tumor syndrome.

Germline and somatic pathogenic variants in the gene, encoding the nuclear protein parafibromin, increase the risk for parathyroid carcinoma and cause hereditary primary hyperparathyroidism (PHPT) syndromes known as familial isolated hyperparathyroidism (FIHP) and hyperparathyroidism-jaw tumor syndrome (HPT-JT). The identification of pathogenic germline variants in PHPT-susceptibility genes can influence surgical planning for parathyroidectomy, guide screening for potential syndromic manifestations, and identify/exonerate at-risk family members. Numerous types of pathogenic germline variants have been described for -related conditions, including deletion, truncating, missense, and splice site mutations.

Inhibition of THBS1 axis contributes to the antitumor effect of PA-MSHA in anaplastic thyroid cancer.

Anaplastic thyroid cancer (ATC) is the most aggressive form of thyroid cancer, has the worst prognosis, and lacks effective treatment in clinical practice. Thrombospondin-1 (THBS1) is a multifunctional extracellular matrix (ECM) glycoprotein that regulates cell proliferation, apoptosis, and metastasis, and is considered a potential clinical biomarker for the monitoring and prognostication of various tumors. However, the specific roles and molecular mechanisms of action of THBS1 in ATC remain unclear.

Synchronous Parathyroid Carcinoma and Breast Carcinoma: A Case Report.

The occurrence of parathyroid carcinoma (PC) is rare, which can lead to difficulties in diagnosis and complicate treatment. However, synchronous PC and breast carcinoma (BC) are rarer, which makes diagnosis and development of a treatment plan more difficult and requires the assistance of clinical evidence, imaging data, and histological examination results. This case report presents a patient with a final diagnosis of synchronous PC and BC.

The role of hormone dosages in the assessment of cervical lesions by FNA: A descriptive analysis of 762 cases.

Introduction: The use of Hormone Dosage (HD) in Fine Needle Aspiration Biopsy (FNA) needle washout fluid, introduced in the 1990s, initially aimed at measuring Thyroglobulin (TG). Elevated TG concentration in an extrathyroidal cervical lesion suggests metastases of Well-Differentiated Thyroid Carcinomas (WDTC). Over the years, HD has evolved to incorporate Calcitonin (CT) and Parathormone (PTH), improving sensitivity and specificity in diverse clinical scenarios.

A case series on parathyroid carcinoma: Diagnostic challenges and therapeutic approaches.

Introduction: Parathyroid carcinoma is an exceptionally rare endocrine malignancy, constituting <1 % of primary hyperparathyroidism (PHPT) cases. It presents with more severe hypercalcemia and higher PTH levels than benign parathyroid diseases, requiring increased clinical awareness for accurate identification and specialized management. The results of this case series may provide insight into the clinical presentation, diagnostic workup, surgical management, and prognosis of parathyroid carcinoma, supplemented by a comprehensive review of current diagnostic and therapeutic approaches.

48-Year clinical experience and genetic analysis of pediatric primary hyperparathyroidism from a single center in China.

Purpose: This study aims to investigate the clinical and genetic features and change of clinical spectrum of primary hyperparathyroidism (PHPT) in children and adolescents.

Methods: The clinical and follow-up data of 74 pediatric patients (onset age ≤ 18 years) with PHPT during 1975-2022 were retrospectively analyzed. For comparison, patients were divided into four subgroups according to their time of diagnosis.

Glycomic profiling of parathyroid neoplasms via lectin microarray analysis.

Purpose: Parathyroid carcinoma (PC) is a rare malignancy with a poor prognosis. Diagnosis of PC is often difficult in clinical practice and efficient diagnostic markers are still needed for differential diagnosis. Aberrant glycosylations of glycoproteins were identified with lectin microarray in various cancers, while relevant information is lacking in PC.