85% of sporadic hyperparathyroidism cases have a solitary adenoma. The remainder of cases have multiple tumors. About 95% of all cases achieve a long remission at initial operation. Adverse outcomes are increased in cases with multiple tumors. The cause of solitary parathyroid adenoma is believed to be mutation of some gene, with overgrowth of a tumor clone. Mutation of the cyclin D1 (PRAD1) gene accounts for about 3-4%. Sporadic (nonhereditary) mutation of the MEN1 gene is the most common known mutation, causing 25-30% of solitary and common variety adenomas. Of the 15% of cases with multigland disease, 5% (1/3 of 15%) have a familial form. Most have familial MEN1 or familial hypocalciuric hypercalcemia. About 1% have familial isolated hyperparathyroidism (FIH). When we tested 40 nonsyndromal kindreds with FIH for occult syndromal mutations, there were no MEN1 mutations but about 10% had CASR mutation or HRPT2 mutation. The underlying gene(s)for the remaining majority of FIH are not known, but mutation of a gene on chromosome 2 seems likely, from linkage analysis. And among all MEN1-like cases without identified mutation, 3.5% have mutation in a cyclin dependent kinase inhibitor gene, specifically p15, p18, p21, or p27.

Project Start
Project End
Budget Start
Budget End
Support Year
36
Fiscal Year
2012
Total Cost
$198,576
Indirect Cost
City
State
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Zip Code
El Lakis, Mustapha; Nockel, Pavel; Gaitanidis, Apostolos et al. (2018) Probability of Positive Genetic Testing Results in Patients with Family History of Primary Hyperparathyroidism. J Am Coll Surg 226:933-938
El Lakis, Mustapha; Nockel, Pavel; Guan, Bin et al. (2018) Familial isolated primary hyperparathyroidism associated with germline GCM2 mutations is more aggressive and has a lesser rate of biochemical cure. Surgery 163:31-34
Guan, Bin; Welch, James M; Vemulapalli, Meghana et al. (2017) Ethnicity of Patients With Germline GCM2-Activating Variants and Primary Hyperparathyroidism. J Endocr Soc 1:488-499
Marx, Stephen J (2016) Hyperplasia in glands with hormone excess. Endocr Relat Cancer 23:R1-14
Keutgen, Xavier M; Nilubol, Naris; Agarwal, Sunita et al. (2016) Reoperative Surgery in Patients with Multiple Endocrine Neoplasia Type 1 Associated Primary Hyperparathyroidism. Ann Surg Oncol :
El-Maouche, Diala; Welch, James; Agarwal, Sunita K et al. (2016) A patient with MEN1 typical features and MEN2-like features. Int J Endocr Oncol 3:89-95
Nilubol, Naris; Weinstein, Lee S; Simonds, William F et al. (2016) Limited Parathyroidectomy in Multiple Endocrine Neoplasia Type 1-Associated Primary Hyperparathyroidism: A Setup for Failure. Ann Surg Oncol 23:416-23
Li, Yulong; Simonds, William F (2016) Endocrine neoplasms in familial syndromes of hyperparathyroidism. Endocr Relat Cancer 23:R229-47
Sadowski, Samira M; Millo, Corina; Cottle-Delisle, Candice et al. (2015) Results of (68)Gallium-DOTATATE PET/CT Scanning in Patients with Multiple Endocrine Neoplasia Type 1. J Am Coll Surg 221:509-17
Marx, Stephen J (2014) Uncoupling of secretion from growth in some hormone secretory tissues. J Clin Endocrinol Metab 99:4051-9

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