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01-04-2014 | Case Report

Water-clear cell adenoma associated with primary hyperparathyroidism: report of a case

Authors: Keigo Murakami, Michio Watanabe, Noriaki Nakashima, Keisei Fujimori, Kazuyuki Ishida, Noriaki Ohuchi, Hironobu Sasano

Published in: Surgery Today | Issue 4/2014

Abstract

We report a case of water-clear cell adenoma associated with primary hyperparathyroidism. A 59-year-old woman with a history of renal stones and bone fracture was referred for investigation of hypercalcemia and an elevated serum parathyroid hormone level. Skeletal X-rays showed osteopenia and ultrasound showed enlarged tumors in both sides of the inferior thyroid region. Computed tomography demonstrated a tumor in the posterior aspect of the left thyroid lobe but no lesion in the right aspect of the neck. Grossly, we found a 500 mg left lower parathyroid gland (PTG) and a 100 mg right lower PTG. Histologically, the left lower PTG comprised mainly water-clear cells (WCCs) containing numerous vacuoles. Chief cells were dispersed among the WCCs, but the right lower PTG showed normal parathyroid tissue. Several investigators have speculated that WCCs are derived from chief cells, and we diagnosed WCC adenoma. Following this case report, we review the relevant literature.

Kovacs K, Horvath E, Ozawa Y, Yamada S, Matushita H. Large clear cell adenoma of the parathyroid in a patient with MEN-1 syndrome. Ultrastructural study of the tumour exhibiting unusual RER formations. Acta Biol Hung. 1994;45:275–84.PubMed

Grenko RT, Anderson KM, Kauffman G, Abt AB. Water-clear cell adenoma of the parathyroid. A case report with immunohistochemistry and electron microscopy. Arch Pathol Lab Med. 1995;119:1072–4.PubMed

Begueret H, Belleannee G, Dubrez J, Trouette H, Parrens M, Velly JF, et al. Clear cell adenoma of the parathyroid gland: a rare and misleading lesion. Ann Pathol. 1999;19:316–9.PubMed

Dundar E, Grenko RT, Akalin A, Karahuseyinoglu E, Bildirici K. Intrathyroidal water-clear cell parathyroid adenoma: a case report. Hum Pathol. 2001;32:889–92.PubMedCrossRef

Kuhel WI, Gonzales D, Hoda SA, Pan L, Chiu A, Giri D, et al. Synchronous water-clear cell double parathyroid adenomas a hitherto uncharacterized entity? Arch Pathol Lab Med. 2001;125:256–9.PubMed

Kanda K, Okada Y, Tanikawa T, Morita E, Tsurudome Y, Konishi T, et al. A rare case of primary hyperparathyroidism with clear cell adenoma. Endocr J. 2004;51:207–12.PubMedCrossRef

Prasad KK, Agarwal G, Krishnani N. Water-clear cell adenoma of the parathyroid gland: a rare entity. Indian J Pathol Microbiol. 2004;47:39–40.PubMed

Kodama H, Iihara M, Okamoto T, Obara T. Water-clear cell parathyroid adenoma causing primary hyperparathyroidism in a patient with neurofibromatosis type 1: report of a case. Surg Today. 2007;37:884–7.PubMedCrossRef

Liang Y, Mojica W, Chen F. Water-clear cell adenoma of parathyroid gland: a case report and literature review. N Am J Med Sci. 2010;3:194–8.CrossRef

10.

Roth SI. The ultrastructure of primary water-clear cell hyperplasia of the parathyroid glands. Am J Pathol. 1970;61:233–48.PubMedCentralPubMed

11.

Emura S, Shoumura S, Isono H. Ultrastructure of the water-clear cell in the rabbit parathyroid gland. Arch Histol Cytol. 1992;55:159–66.PubMedCrossRef

12.

Baloch ZW, LiVolsi VA. Double adenoma of the parathyroid gland: does the entity exist? Arch Pathol Lab Med. 2001;125:178–9.PubMed

13.

Albright F, Bloomberg E, Castleman B. Hyperparathyroidism due to diffuse hyperplasia of all parathyroid glands rather than adenoma of one. Arch Intern Med. 1934;54(3):315–29.

14.

Hoefler H, Denk H, Lackinger E, Helleis G, Polak JM, Heitz PU. Immunocytochemical demonstration of intermediate filament cytoskeleton proteins in human endocrine tissues and (neuro-) endocrine tumours. Virchows Arch A Pathol Anat Histopathol. 1986;409:609–26.PubMedCrossRef

15.

Miettinen M, Clark R, Lehto VP, Virtanen I, Damjanov I. Intermediate-filament proteins in parathyroid glands and parathyroid adenomas. Arch Pathol Lab Med. 1985;109:986–9.PubMed

16.

Chen H, Emura S, Shoumura S. Ultrastructure of the water-clear cell in the parathyroid gland of SAMP6 mice. Tissue Cell. 2006;38:187–92.PubMedCrossRef

17.

Dawkins RL, Tashjian AH Jr, Castleman B, Moore EW. Hyperparathyroidism due to clear cell hyperplasia. Serial determinations of serum ionized calcium, parathyroid hormone and calcitonin. Am J Med. 1973;54:119–26.PubMedCrossRef

Title: Water-clear cell adenoma associated with primary hyperparathyroidism: report of a case
Authors: Keigo Murakami
Michio Watanabe
Noriaki Nakashima
Keisei Fujimori
Kazuyuki Ishida
Noriaki Ohuchi
Hironobu Sasano
Publication date: 01-04-2014
Publisher: Springer Japan
Published in: Surgery Today / Issue 4/2014
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI: https://doi.org/10.1007/s00595-013-0568-7

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Water-clear cell adenoma associated with primary hyperparathyroidism: report of a case

Abstract

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