A 66-year-old woman presented with hypercalcemia and a past history of external radiation to the neck. Hyperparathyroidism in this patient was caused by a parathyroid adenoma. The literature associating hyerparathyroidism with prior radiation of the head and neck was reviewed and analyzed. Current evidence supports a relationship between external radiation of the head or neck and the development of hyperparathyroidism as a late complication. Analysis of data available suggests that radiation-association hyperparathyroidsim develops after an average latent period of 38 years. Parathyroid adenoma occurred more often than did hyperplasia. Parathyroid carcinoma has not been reported in irradiated patients with hyperparathyroidsim. Neither age at radiation exposure, age at diagnosis of hyperparathyroidsim, nor interval between exposure and diagnosis was associated with a specific histologic diagnosis (adenoma or hyperplasis).

Adenoma↗

PubMedDate not supplied

Epinephrine fraction of adrenal vein blood in pheochromocytoma.

Variability in the levels of epinephrine (E) and norepinephrine (NE) in adrenal vein blood is thought to preclude their usefulness in caval sampling studies for localizing abdominal pheochromocytoma. In this study we demonstrate, in three patients, that the fraction of the total catecholamine level in the adrenal effluent represented by E (E fraction) may differentiate the normal adrenal medulla from the gland containing a pheochromocytoma. This observation is additionally supported by calculations of the E fractions, from adrenal venous E and NE reported recently, in three other patients with pheochromocytoma. Our data, combined with those from the literature, yield a mean E fraction, in adrenal vein blood, of 63.8 +/- 11.4 (SD)% for seven normal adrenal medullae, and of 28.5 +/- 4.8% for five glands bearing pheochromocytoma. The use of this parameter for lateralizing adrenal pheochromocytoma is suggested if other procedures are unable to demonstrate the tumor.

Adrenal Gland Neoplasms↗