Document Detail


Primary paraganglioma of the parathyroid: a case report and clinicopathologic review.
MedLine Citation:
PMID:  20237987     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Paragangliomas are relatively uncommon neoplasms that arise in adrenal and extra-adrenal paraganglia of the autonomic nervous system. Parasympathetic paraganglioma develop predominantly in the head and neck. It is exceedingly uncommon to develop a primary intraparathyroid paraganglioma. There is only a single case report in the English literature. The information from the single previous case report (Medline 1960-2009) was combined with this case report. Our patient was a 69 year old woman who presented with a thyroid gland mass, with extension into the substernal space. The patient had a history of renal cell carcinoma removed 18 months before. At surgery, a thyroid lobectomy and a parathyroidectomy were performed. The parathyroid tissue showed a very well defined zellballen arrangement of paraganglion cells within the parenchyma of the parathyroid gland. The cells had ample basophilic, granular cytoplasm. The nuclei were generally round to oval with 'salt-and-pepper' nuclear chromatin distribution. There was a richly vascularized stroma. Mitotic figures, necrosis, invasive growth, and profound nuclear pleomorphism were absent. The neoplastic cells were strongly and diffusely immunoreactive with chromogranin, synaptophysin, CD56, and focally with cyclin-D1. The paraganglioma showed a delicate S-100 protein positive supporting sustentacular framework. Keratin, CD10, PTH, calcitonin and RCC markers were negative. The patient showed no stigmata of Multiple Endocrine Neoplasia (MEN) and has no paraganglioma in any other anatomic site. She is alive without any additional findings 12 months after surgery. Isolated paraganglioma within the parathyroid is rare, and should be separated from parathyroid adenoma, hyperplasia or metastatic disease to assure appropriate management.
Authors:
Michael T Levy; John T Braun; Marjorie Pennant; Lester D R Thompson
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Publication Detail:
Type:  Case Reports; Journal Article; Review     Date:  2009-12-24
Journal Detail:
Title:  Head and neck pathology     Volume:  4     ISSN:  1936-0568     ISO Abbreviation:  Head Neck Pathol     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-18     Completed Date:  2010-09-02     Revised Date:  2010-12-28    
Medline Journal Info:
Nlm Unique ID:  101304010     Medline TA:  Head Neck Pathol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  37-43     Citation Subset:  IM    
Affiliation:
Department of Pathology, Southern California Permanente Medical Group, Woodland Hills Medical Center, 5601 De Soto Avenue, Woodland Hills, CA 91365, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Antigens, CD56 / metabolism
Cell Nucleus / pathology
Chromogranins / metabolism
Cyclin D1 / metabolism
Disease-Free Survival
Female
Humans
Paraganglioma, Extra-Adrenal / metabolism,  pathology*,  surgery
Parathyroid Neoplasms / metabolism,  pathology*,  surgery
Synaptophysin / metabolism
Thyroidectomy
Tumor Markers, Biological / metabolism
Chemical
Reg. No./Substance:
0/Antigens, CD56; 0/CCND1 protein, human; 0/Chromogranins; 0/Synaptophysin; 0/Tumor Markers, Biological; 136601-57-5/Cyclin D1

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