Gamma probe-assisted excision of an ectopic parathyroid adenoma located within the thymus: case report and review of the literature

Journal of Cardiothoracic Surgery

Avraam Ploumis¹  Michael Sapranidis³  Konstantinos Ioannidis²  Omiros Zografos²  Varvara Pantelidou²  Savvas Lampridis⁴  George Chatzoulis²  Stavros I Daliakopoulos⁴ 

[1] Department of Orthopaedic Surgery and Rehabilitation, University Hospital of Ioannina, Stavrou Niarchou Avenue, Ioannina Gr 45 500, Greece;Department of Surgery, 424 General Military Hospital, Eukarpia Ring Road, Thessaloniki Gr 564 29, Greece;Department of Endocrinology, Hippokration Hospital, Konstantinoupoleos 49, Thessaloniki Gr 546 42, Greece;Department of Thoracic Surgery, 424 General Military Hospital, Eukarpia Ring Road, Thessaloniki Gr 564 29, Greece

关键词: Gamma probe;    ^99mTc sestamibi;    Ectopic parathyroid adenoma;   

Others  :  810963
DOI  :  10.1186/1749-8090-9-62

 received in 2013-11-25, accepted in 2014-03-20,  发布年份 2014

【 摘 要 】

Primary hyperparathyroidism due to parathyroid adenomas may be associated with ectopic parathyroid gland localization in 20-25% of the patients. We report herein the excision of an ectopic parathyroid adenoma which was detected in the thymus gland by gamma probe intraoperatively. A 38-year-old patient presented to our clinic with a history of bilateral nephrolithiasis, chronic hypercalcaemia, and PTH elevation. A combination of Technetium-99 m sestamibi scintigraphy and Computed Tomography scan of the chest and neck revealed an ectopic parathyroid adenoma of 8.5 mm in its greatest dimension. The patient underwent sternotomy and the adenoma was found within the right lobe of the thymus gland with the intraoperative use of gamma probe. PTH detection and frozen biopsy were performed during surgery and confirmed the successful excision of the adenoma, while mild hypocalcaemia was noticed postoperatively. We conclude that accurate preoperative and intraoperative localization of an ectopic parathyroid adenoma is crucial to successful surgery. The use of at least two diagnostic modalities before surgical excision minimizes the risk of re-operation for recurrent hyperparathyroidism, while the intraoperative use of gamma probe offers a significant advantage over conventional techniques by reducing surgical time, morbidity and/or complications associated with surgical exploration.

【 授权许可】

   
2014 Daliakopoulos et al.; licensee BioMed Central Ltd.

【 图 表 】

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