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

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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.

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References

  1. 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.

    CAS  PubMed  Google Scholar 

  2. 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.

    CAS  PubMed  Google Scholar 

  3. 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.

    CAS  PubMed  Google Scholar 

  4. 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.

    Article  CAS  PubMed  Google Scholar 

  5. 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.

    CAS  PubMed  Google Scholar 

  6. 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.

    Article  PubMed  Google Scholar 

  7. 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  Google Scholar 

  8. 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.

    Article  PubMed  Google Scholar 

  9. 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.

    Article  Google Scholar 

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

    CAS  PubMed Central  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

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

    CAS  PubMed  Google Scholar 

  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.

    Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

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The authors have no conflict of interest to declare.

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Authors and Affiliations

  1. Division of Transplantation, Reconstruction and Endoscopic Surgery, Tohoku University Hospital, 1-1 Seiryou-machi, Aoba-ku, Sendai, 980-8574, Japan

    Keigo Murakami

  2. Division of Surgical Oncology, Tohoku University Hospital, 1-1 Seiryou-machi, Aoba-ku, Sendai, 980-8574, Japan

    Michio Watanabe, Noriaki Nakashima, Keisei Fujimori & Noriaki Ohuchi

  3. Division of Pathology, Tohoku University Hospital, 1-1 Seiryou-machi, Aoba-ku, Sendai, 980-8574, Japan

    Kazuyuki Ishida & Hironobu Sasano

Authors
  1. Keigo Murakami
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  2. Michio Watanabe
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  3. Noriaki Nakashima
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  4. Keisei Fujimori
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  5. Kazuyuki Ishida
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  6. Noriaki Ohuchi
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  7. Hironobu Sasano
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Correspondence to Keigo Murakami.

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Murakami, K., Watanabe, M., Nakashima, N. et al. Water-clear cell adenoma associated with primary hyperparathyroidism: report of a case. Surg Today 44, 773–777 (2014). https://doi.org/10.1007/s00595-013-0568-7

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  • DOI: https://doi.org/10.1007/s00595-013-0568-7

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