An unusual presentation of parathyroid adenoma--a case report

A case of intrathyroid parathyroid adenoma which clinically and cytologically mimicked thyroid tumor is presented. The patient was normocalcemic inspite of clinical and radiological features suggestive of hyperparathyroid bone disease. The adenoma showed an area of infarction presumably accounting for the normocalcemic primary hyperparathyroidism. The case is reported for its unusual presentation.     

An unusual case of hip disability--(a case report)

An unusual case of postero-superior periarticular irritation of the hip joint of six months' duration due to an extension of a pre-sacral foreign body granuloma in an 18 year old unmarried girl is presented. Two wooden sticks which probably were inserted pervaginally by a village midwife to induce an abortion for an unwanted pregnancy had found its way to presacral region. The scanning of the vaginal fornix indicated a possible route through which the sticks might have been migrated.     

Intrathyroidal water-clear cell parathyroid adenoma: a case report

Adenomas of the parathyroid gland, the majority of which contain mixed cell populations, are the most frequent cause of primary hyperparathyroidism. Parathyroid adenomas composed exclusively of water-clear cells are exceptionally rare. Until now, only 2 cases have been reported in English literature. We report a water-clear cell adenoma of the parathyroid gland in an intrathyroidal position, which has not been described previously according to our knowledge.     

An unusual cause of hypercalcemia in polycythemia vera: parathyroid adenoma

In this paper we describe a patient with polycythemia vera (PV), who presented with hypercalcemia due to a parathyroid adenoma. In November 1999, the patient was admitted to our hospital with meteorism and constipation. Her physical examination revealed plethora and hepatosplenomegaly. Laboratory data revealed hyperparathyroidism in addition to PV: Rbc 8 x 10(6)/mm3, Hct 63.7%, serum calcium 13.4 mg/dl, serum phosphorus 1.2 mg/dl, albumin 4.25 mg/dl, and alkaline phophatase activity 433 U/l. Intact Parathyroid Hormone level (iPTH) was 376 pg/ml (n.v.12-72 pg/ml). Twenty-four hour urinary calcium excretion was higher than normal (900 mg). A parathyroid adenoma was detected with Tc-99m sesta-MIBI scanning under the left lobe of the thyroid gland and an ultrasonographic examination of the neck also supported the diagnosis. The patient was recommended for surgery. The histopathological examination confirmed the diagnosis. Postoperatively, iPTH dropped to 53.4 pg/ml at the 15 th minute and to 33.5 pg/ml at the first hour. The calcium level was 7.5 mg/dl one hour after the operation. Five days later, Hct was 40.8%. This case represents a rare association between PV and primary hyperparathyroidism, and may provide evidence for a causal link between PTH and polycythemia vera in our patient. In conclusion, this case indicates that the differential diagnosis of hypercalcemia and polycythemia vera should also include the possibility of a parathyroid tumor in addition to malignancy.     

An unusual case of haemophilia--a case report

Haemophilia in a female is very rare. We report a case of haemophilia in a female with a male sex chromosome pattern.     

An unusual double patella: a case report

Double patella following a 'sleeve fracture' in the lower pole of the patellar is rare and even more so after surgical treatment to the original injury. We report such a case in a boy injured at the age of 10, and presenting 3 years later with weakness and effusion. The management is described, including the technique of excision of the accessory patella and the lowering of the larger patella to a normal level. We believe that this is the first such case to be reported after surgical treatment of the primary fracture.     

Hyalinizing parathyroid adenoma and hyperplasia: report of 3 cases of an unusual histologic variant

Fibrosis in the parathyroid glands can be seen in adenomas, in carcinomas, and after fine needle aspiration of the thyroid gland. Fibrosis occurs in approximately 10% of typical adenomas and in all atypical adenomas. This is usually in the form of fibrous bands or trabeculae that intersect the hypercellular parenchyma. However, widespread diffuse fibrosis or sclerosis in either parathyroid gland hyperplasia or adenoma has not been reported before in the English medical literature. We report 3 cases of hyperparathyroidism (2 adenomas and 1 hyperplasia) with an unusual pattern of sclerosis. The hyalinized, eosinophilic fibrous tissue was diffusely distributed within and around the parathyroid parenchyma, often isolating groups of cells and single cells.     

An unusual presentation of myxoid liposarcoma: a case report

A 50 year old female had a myxoid liposarcoma of left thigh that was widely excised. After three years, she presented with a soft tissue mass in right hypochondriac region, which was diagnosed as myxoid liposarcoma on fine needle aspiration cytology (FNAC) and was confirmed histologically.     

Metastatic breast carcinoma to parathyroid adenoma on fine needle cytology sample: report of a case

Metastases to the thyroid gland diagnosed by means of fine needle cytology or by excision have been reported in the literature. To our knowledge, metastatic neoplasms to the parathyroid gland have never been described up to now. In this article, we introduce a rare case of metastatic breast carcinoma to a parathyroid adenoma in a 56-year-old woman, which clinically simulated a left thyroid nodule. The patient had a history of left breast carcinoma; the recent discovery of a palpable mass in the left thyroid area had elicited fine needle cytology sampling for its diagnostic evaluation. The obtained cytopathological sample was cellular but limited to a single Diff-Quik-stained smear; hence, no ancillary studies could be entertained. A cytopathological diagnosis of positive for malignant cells of query metastatic breast origin was performed. The permanent histopathological examination of the surgical sample disclosed multiple small foci of metastatic high-grade carcinoma of ductal type within a somewhat atypical adenoma of the parathyroid gland. The cytopathological findings and some differential diagnostic considerations are briefly commented, as well as the deranging imaging data concerning this interesting case.     

An unusual infected hydrocele--a case report.

Of acute scrotal lesions in the neonates, cases needing emergent exploration are quite rare and differential diagnosis of them is not easy. Only a few cases of inflamed hydroceles occurring in young boys have been reported to have been caused by bacterial infection in the literature. We couldn''t find any case concerning simultaneous bacterial infection in urine and hydrocele by the same organisms. We present an unusual case of infected hydrocele in a neonate with bacteriuria.