Parathyroid Adenoma Treated With X-Ray and Surgery
The purpose of this report is to present a case of parathyroid adenoma removed surgically after treatment elsewhere with x-ray. Although surgical excision is the commoner treatment of adenoma of the parathyroids, cases in which irradiation to the parathyroid region has brought about some improvement have been reported. Merritt and Lattman1 reported seven cases in which irradiation produced not only symptomatic relief but also some regression of bone changes. However, it is possible that parathyroid lesions treated with x-ray may not be true adenomas. This case offered an opportunity to examine a true adenoma removed by excision after treatment with x-ray and to consider changes possibly produced in the gland by irradiation.
A white woman, aged 40, was first seen on September 25, 1943. She complained of a lump in her jaw. In 1936 she noted a swelling in the left mandible, which slowly increased in size. In 1939 a tender tumor appeared on the right jaw, and the patient, who was an active, alert person, became lethargic and easily fatigued. In May 1940 she received an unknown amount of irradiation to the entire j aw and over the neck generally, and thereafter she thought that she was less drowsy.
In 1942 she became extremely nervous, irritable, and emotionally unstable and frequently had severe left frontal and parietal headaches, which continued until her admission to the hospital on November 2, 1943.
Physical examination revealed a well developed, well nourished woman with tumors of both rami of the mandible,. . .