Symptomatic spinal intradural arachnoid cysts in the pediatric age group: Description of three new cases and review of the literature

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Title:	Symptomatic spinal intradural arachnoid cysts in the pediatric age group: Description of three new cases and review of the literature
Authors:	Lee, HJ;Cho, DY
Contributors:	附設醫院神經外科;China Med Coll Hosp, Dept Neurosurg, Taichung, Taiwan
Date:	2001
Issue Date:	2010-09-24 14:42:31 (UTC+8)
Publisher:	KARGER
Abstract:	The major factor to influence localization of parathyroid adenomas is tumor size. P-glycoprotein (P-gp) expression in parathyroid adenomas has been considered to be an another possible factor to influence localization of parathyroid adenomas because false-negative studies have been reported with large tumors and true-positives reported with very small tumors in previous studies. The aim of this study was to characterize Tc-99m MIBI uptake and retention by parathyroid adenomas and to correlate this with cell surface expression of P-gp. Sixteen patients with parathyroid adenoma (larger than 1.5 gm) underwent dual-phase (10min and 2hr) Tc-99m MIBI parathyroid image immediately before parathyroid exploration. Tissues were obtained from normal and abnormal parathyroid glands and from the thyroid gland. Immunohistochemistry (IHC) was obtained with monoclonal antibodies to identify P-gp expression in all tissues. All of the 16 parathyroid adenomas and 32 normal control specimens (16 normal parathyroid and 16 normal thyroid specimens) were submitted for P-gp detection by IHC. The dual-phase Tc-99m MIBI parathyroid image accurately localized 14 parathyroid adenomas, but not the remaining 2 adenomas. The 14 parathyroid adenomas with significant Tc-99m MIBI uptake in delayed 2hr images revealed negative P-gp expression, but the 2 adenomas without significant Tc-99m MIBI uptake, as well as normal parathyroid and normal thyroid specimens, revealed positive P-gp expression when evaluated by IHC. Not only the size of parathyroid adenomas, but also significant P-gp expression limited the sensitivity of dual-phase Tc-99m MIBI parathyroid image to localize parathyroid adenomas before operation. (C) 2001 Elsevier Science Inc. All rights reserved.
Relation:	PEDIATRIC NEUROSURGERY 35(4):181-187
Appears in Collections:	[China Medical University Hospital] Jurnal articles

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