title: Synchronous water-clear cell double parathyroid adenomas a hitherto uncharacterized entity?
abstract: Water-clear cell hyperplasia is a rare but well-documented cause of primary hyperparathyroidism. Parathyroid adenomas of the water-clear cell type are exceptionally rare, and only 2 cases have been reported. We describe a patient with synchronous water-clear cell double parathyroid adenomas, an entity that has not previously been reported. In our case, the enlarged superior parathyroid glands were completely replaced by water-clear cells, with only a minute rim of extracapsular, histologically unremarkable parathyroid tissue. The inferior parathyroid glands were grossly unremarkable, and incisional biopsy specimens were histologically normal (no foci of water-clear cells were identified). The findings in this case are most consistent with the diagnosis of double adenomas of the water-clear cell type. We acknowledge that despite molecular proof of monoclonality of the 2 lesions, it is not possible to entirely exclude the possibility that this unusual case could be due to asymmetric hyperplasia.
authors.affiliation: Department of Otorhinolaryngology, New York Presbyterian Hospital-Weill Medical College of Cornell University, New York, NY 10021, USA.
authors.forename: W I
authors.initials: WI
authors.lastname: Kuhel
authors.forename: D
authors.initials: D
authors.lastname: Gonzales
authors.forename: S A
authors.initials: SA
authors.lastname: Hoda
authors.forename: L
authors.initials: L
authors.lastname: Pan
authors.forename: A
authors.initials: A
authors.lastname: Chiu
authors.forename: D
authors.initials: D
authors.lastname: Giri
authors.forename: R A
authors.initials: RA
authors.lastname: DeLellis
mesh_terms: D000236:Adenoma / Q000235:genetics / Q000473:pathology* / Q000601:surgery; D001706:Biopsy; D002999:Clone Cells; D005260:Female; D008040:Genetic Linkage; D006801:Humans; D006961:Hyperparathyroidism / Q000209:etiology; D006965:Hyperplasia; D007150:Immunohistochemistry; D008875:Middle Aged; D010280:Parathyroid Glands / Q000473:pathology* / Q000601:surgery; D010281:Parathyroid Hormone / Q000097:blood; D010282:Parathyroid Neoplasms / Q000235:genetics / Q000473:pathology* / Q000601:surgery; D016133:Polymerase Chain Reaction; D011944:Receptors, Androgen / Q000235:genetics; D014617:Vacuoles / Q000473:pathology; D014960:X Chromosome
chemical_list: D010281:Parathyroid Hormone; D011944:Receptors, Androgen