Technetium and thallium double-labeling scintigraphy with image subtraction was carried out on 63 patients suspected of having primary hyperparathyroidism, with or without thyroid involvement. Forty-four patients had a normal thyroid image with technetium. The positive foci located by double-labeling in patients who were to undergo surgery always coincided with parathyroid adenoma. In the 16 cases where the initial diagnosis of hyperparathyroidism was not substantiated, the double-labeling test was normal. Thus for these 44 patients, scintigraphy sensitivity was 75% and specificity was 100%. Nineteen patients had an abnormal thyroid image with technetium. In 7 cases, image subtraction following double-labeling yielded uninterpretable data. In 12 other patients, the positive foci located outside the thyroid by double-labeling coincided with a parathyroid adenoma, whereas this was true for only one patient whose positive foci were located inside the thyroid; a parathyroid adenoma was not detected preoperatively in 4 patients. This double-labeling test is thus useful in locating parathyroid adenomas when technetium scintigraphy of the thyroid is normal; when it is abnormal, double-labeling is advantageous only in cases of extra-thyroid foci.

A case of splenic volvulus, a rare complication of a rare malformation, mobile spleen, is reported, only 150 similar cases being documented in the literature. The diagnosis can be suspected preoperatively by ultrasound imaging. Different etiologies of this lesion are discussed and the various complementary examinations allowing preoperative diagnosis described.

Letters and Corrections1 March 1987Bronchial Carcinoid Tumor and HypercalcemiaE. SARFATI, A. LAVERGNE, D. GOSSOT, D. FISCHER, C. DUBOSTE. SARFATISearch for more papers by this author, A. LAVERGNESearch for more papers by this author, D. GOSSOTSearch for more papers by this author, D. FISCHERSearch for more papers by this author, C. DUBOSTSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-106-3-476_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: We report a case of bronchial carcinoid tumor concomitant with hypercalcemia in which the hypercalcemia disappeared after excision of the lesion.A 64-year-old man was admitted to our department because of persistent hypercalcemia after an unsuccessful cervicotomy for suspected primary hyperparathyroidism. Two years ago, his serum calcium level was normal, and a chest radiograph of the right lung showed a small opacity that was disregarded Three months before admission, the patient had progressive and severe asthenia. Clinical findings were normal. A chest radiograph showed a high-density nodule in the right lung. Blood chemistry tests revealed hypercalcemia, 155...References1. HURTBATES RM. Carcinoid tumors of the bronchus: 33 years experience. Thorax. 1984;39:617-23. CrossrefMedlineGoogle Scholar2. MCCAUGHANMARTINIBAINS BNM. Bronchial carcinoid-review of 124 cases. J Thorac Cardiovasc Surg. 1985;89:8-17. CrossrefMedlineGoogle Scholar3. MAXLAWRENCE MP. Ectopic secretion of parathyroid hormone. Surg. Gynecol Obstet. 1980;150:411-8. MedlineGoogle Scholar4. SANOSAITOYAMASAKI THR. Immunoreactive somatostatin and calcitonin in pulmonary neuroendocrine tumor. Cancer. 1986;57:64-8. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: E. SARFATI; A. LAVERGNE; D. GOSSOT; D. FISCHER; C. DUBOSTAffiliations: Hôpital Saint-Louis 75010 Paris France PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byWhat Lies behind Paraneoplastic Hypercalcemia Secondary to Well-Differentiated Neuroendocrine Neoplasms? A Systematic Review of the LiteratureCase Report: Unmasking Hypercalcemia in Patients With Neuroendocrine Neoplasms. Experience From Six Italian Referral Centers 1 March 1987Volume 106, Issue 3Page: 476-477KeywordsBlood chemistryCalciumCarcinoid tumorHypercalcemiaHyperparathyroidismLesionsLungsPatient advocacyThorax ePublished: 1 December 2008 Issue Published: 1 March 1987 PDF downloadLoading ...

An exceptional case of gastropericardial fistula is reported, the lesion developing from a gastric ulcer on an antireflux valve instituted ten years previously. A literature review showed 31 similar cases: 14 gastropericardial fistulae, 16 esophagopericardial fistulae and one jejunopericardial fistula. Three features common to all these fistulae were determined: the frequency of hiatus hernia in the genesis of these lesions, either from an ulcer on esophagitis or herniated stomach or from surgical complication; the extremely high mortality of these fistulae (68% mortality); the need for aggressive treatment.

A case of parathyroid adenoma is reported which was of interest in two respects: the very atypical localization in the middle mediastinum and the clearly visible lesion on a straight thoracic film.

Hyperparathyroidism is a frequent, often fortuitous finding in elderly people. Our series includes 103 patients over 70 years of age, 90 of whom were operated upon. Elderly patients rarely are without any symptom, but it is difficult, prior to surgery, to associate their clinical disorders with hyperparathyroidism. Our results show that surgical treatment is virtually without danger and that most patients were distinctly improved. The innocuousness and effectiveness of surgery in these patients, as well as the absence of medical treatment are as many reasons to widen the indications of the surgical approach.