Multiple ectopic parathyroid adenomas

Sao Paulo Medical Journal

Rogério Aparecido Dedivitis²  André Vicente Guimarães¹  Gustavo Bastos De Goes Pontes¹ 

[1] ,Universidade Metropolitana de Santos Department of Otorhinolaryngology, Head and Neck Surgery Santos São Paulo ,Brazil

关键词: Parathyroid glands;    Hyperparathyroidism;    Parathyroidectomy;    Parathyroid neoplasms;    Glândulas paratireóides;    Hiperparatireoidismo;    Paratireoidectomia;    Neoplasias das paratireóides;   

DOI  :  10.1590/S1516-31802004000100008

来源: SciELO

【 摘 要 】

CONTEXT: Primary hyperparathyroidism is the most common cause of hypercalcemia in unselected patients. The ectopic gland locations should be known for appropriate surgical exploration and for avoiding subsequent re-exploration that would represent higher morbidity. Multiple ectopic glands are rare and present a particular challenge in parathyroid surgery. CASE REPORT: A 65-year-old female presented with nephrolithiasis. Her serum total calcium was found to be elevated. The diagnosis of primary hyperparathyroidism was confirmed by the elevated serum intact parathyroid hormone levels. Ultrasound was only successful in localizing one adenoma in the lower right gland. Technetium sestamibi scanning correctly localized the same adenoma and showed another contralateral image, lateral to the thyroid cartilage. Fiber optic laryngoscopy showed an extrinsic mass pushing against the lateral and posterior walls of the left pyriform sinus. Resonance imaging revealed a soft tissue mass. RESULTS: The patient underwent bilateral neck exploration. Histopathological examination confirmed the diagnosis of parathyroid double adenomas. The late-stage postoperative checkups were normal. DISCUSSION: Routine bilateral neck surgery should be performed as a rule. We use ultrasound and technetium sestamibi scanning as a routine for preoperative localization studies. It is helpful to have an experienced surgeon for the localization.

【 授权许可】

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