title: Water-clear cell adenoma associated with primary hyperparathyroidism: report of a case.
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.
authors.affiliation: Division of Transplantation, Reconstruction and Endoscopic Surgery, Tohoku University Hospital, 1-1 Seiryou-machi, Aoba-ku, Sendai, 980-8574, Japan, kehgo@med.tohoku.ac.jp.
authors.forename: Keigo
authors.initials: K
authors.lastname: Murakami
authors.forename: Michio
authors.initials: M
authors.lastname: Watanabe
authors.forename: Noriaki
authors.initials: N
authors.lastname: Nakashima
authors.forename: Keisei
authors.initials: K
authors.lastname: Fujimori
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Ishida
authors.forename: Noriaki
authors.initials: N
authors.lastname: Ohuchi
authors.forename: Hironobu
authors.initials: H
authors.lastname: Sasano
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000150:complications* / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology; D049950:Hyperparathyroidism, Primary / Q000209:etiology*; D008875:Middle Aged; D010280:Parathyroid Glands / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D010282:Parathyroid Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D011859:Radiography; D016896:Treatment Outcome
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