Rare case of a giant parathyroid adenoma

Česká verze

Authors: M. Linhartová ¹; L. Mitáš ¹; K. Starý ²
Authors place of work: Chirurgická klinika LF Masarykovy univerzity a FN Brno přednosta: prof. MUDr. Z. Kala, CSc. ¹; Endokrinologická ambulance Interní a gastroenterologické kliniky LF Masarykovy univerzity a FN Brno přednosta: prof. MUDr. A. Hep, CSc. ²
Published in the journal: Rozhl. Chir., 2016, roč. 95, č. 12, s. 453-456.
Category: Kazuistika

Summary

Currently, primary hyperparathyroidism is the third most common endocrine disorder worldwide. In the last years, though, the numbers of patients with this diagnosis have been clearly increasing. Females are affected more often, and the age of patients is usually over 50 years. The diagnosis is guided by clinical symptoms of the patient and by biochemical and imaging methods results. [1] When parathyroid adenoma is identified as the source of primary hyperparathyroidism, the necessary extent of resection is performed. The present case involved a rapid diagnostic process necessary to stabilize the patient, together with localization of the adenoma for the indicated surgery. Ultrasound-guided exploration found a surprisingly large tumour of the parathyroid gland causing the acute clinical condition with symptoms suggestive of primary hyperparathyroidism with discrete mechanical compression of the upper mediastinum.

Key words:
critical diagnosis of hyperparathyroidism −⁠ acute-active parathyroid adenoma −⁠ extirpation of a huge parathyroid tumour –⁠ normalization of the clinical condition

Zdroje

1. Šiprová H, Souček M, Šipr K. Nové pohledy na primární hyperparatyreózu v internistické praxi. Interni Med 2016;18 : 134–6.

2. Broulík P. Hyperparatyreóza −doporučené postupy pro praktické lékaře. JEP IGA 2001;5390−3 : 2.

3. Salehian MT, Namdari O, Mohammadi SS, et al. Primary hyperparathyroidism due to a giant parathyroid adenoma: A case report. Int J Endocrinol Metab 2009;2 : 101−5.

4. Takeichi N, Nishida T, Fujikura T, et al. Two cases of large functioning parathyroid adenomas in atomic bomb survivors. Gan No Rinsho 1983;29 : 851−4.

5. Kammori M, Fukami T, Ogawa T, et al. Giant mediastinal cystic parathyroid adenoma. The Journal of Clinical Endocrinology & Metabolism 2006;91 : 1635−6.

6. Thrower S, Denley A, Chen M, et al. Giant parathyroid adenoma extending into the mediastinum; a case report. Endocrine Abstracts 2013;DOI:10.1530/endoabs.31 : 78.

7. Adámek S, Naňka O. Primární hyperparathyreóza: Diagnostika a terapie. Praha, Galen 2006.

8. Berri RN, Lloyd LR. Detection of parathyroid adenoma in patients with primary hyperparathyroidism: The use of office-based ultrasound in preoperative localization. The American Journal of Surgery 2006;191 : 311−4.

9. Toft AD. Surgery for primary hyperparathyroidism sooner rather than later. Lancet 2000;355 : 1478−9.

10. Libánský P, Broulik P, Křížová H, et al. Význam předoperačních a peroperačních lokalizačních vyšetření u primární hyperparatyreózy.DMEV II/2006;85−9.