Primary hyperparathyreosis due to an ectopic parathyroid adenoma in the upper mediastinum as a cause of hypercalcaemia: case report
Authors:
K. Bielaková 1; H. Matějovská-Kubešová 1; P. Weber 1; I. Černý 2; M. Číhalová 3; T. Gregorová 1
Authors‘ workplace:
Přednosta: doc. MUDr. Josef Feit, CSc.
; Přednosta: doc. MUDr. Jiří Prášek, CSc.
; Přednosta: prof. MUDr. Hana Matějovská-Kubešová, CSc.
; Klinika interní, geriatrie a praktického lékařství, LF MU a FN Brno
1; Klinika Nukleární mediciny FN Brno
2; Ústav patologie FN Brno
3
Published in:
Prakt. Lék. 2011; 91(10): 614-618
Category:
Case Report
Overview
The case study reports on one of frequent causes of hypercalcaemia - parathyroid adenoma. It holds one of the first places in the differential diagnosis of hypercalcaemia. It is necessary to think about location of adenoma, which may not be identified when it is located ectopically.
The cause of hypercalcaemia can be detected by using special biochemical tests, which should be extended by other imaging methods such as
– ultrasound,
– CT,
– MRI, or
– radionuclide techniques using methoxyizobutylizonitrile (MIBI) labelled with technetium 99.
We must actively search clinical signs of diseased
– kidney,
– bones,
– gastrointestinal tract,
– heart and other systems.
It should be remembered that in many cases, hypercalcaemia is asymptomatic. Interdisciplinary collaboration is key to proper diagnosis and treatment solutions.
Key words:
hypercalcaemia, primary hyperparathyroidism, pHPT, aetiology.
Sources
1. Assadi, F. Hyperkalcemia: an evidence-based approach to clinical cases. Iran J. Kidney Dis. 2009, 3(2), p. 71-79.
2. Bilezikian, J.P., Silverberg, S.J. Normocalcemic primary hyperparathyroidism. Arq. Bras. Endocrinol. Metabol. 2010, 54(2), p. 106-109.
3. Bláha, V., Pidrman, V., Nožička, J. a kol. Primární hyperparathyreosa - hyperkalcemické koma pod obrazem akutního amentního stavu. Geriatria 1997, 3(2), s. 6-9.
4. Broulík, P. Diferenciální diagnostika hyperkalcemií. Vnitř. Lék. 2007, 53(7-8), s. 826-830.
5. Broulík, P., Adámek, S., Libánský, P., Tvrdoň, J. Diagnostika a léčba primární hyperparatyreózy. Interní medicina pro praxi 2007, 3, s. 130-132.
6. Bruna, J., Brunová, J. Klinická endokrinologie a zobrazovací metody endokrinopatií. 1 vyd. Praha: Maxdorf 2009, s. 253-269.
7. Hotes, L.S., Barzilay, J., Cloud, L.P., Rolla, A.R. Spontaneous hematoma of a parathyroid adenoma. Am. J. Med. Sci. 1989, 297(5), p. 331-333.
8. Jabor, A. a kol. Vnitřní prostředí. Praha: Grada 2008: s. 72-90.
9. Lewiecki, E.M. Management of skeletal health in patients with asymptomatic primary hyperparathyroidism. Clin. Densitom. 2010, 13(4), p. 324-34.
10. Libánský, P., Broulík, P., Křížová, H. a kol. Význam předoperačních a peroperačních lokalizačních vyšetření u primární hyperparatyreózy. Diabetologie, metabolizmus, endokrinologie, výživa, 9(2), s. 78-82.
11. Lucas, D.G. Jr., Lockett, M.A., Cole, D.J. Spontaneous infarction of a parathyroid adenoma: two case reports and review of the literature. Am. Surg. 2002, 68(2), p. 173-176.
12. Marek, J. a kol. Farmakoterapie vnitřních onemocnění. 4 vyd. Praha: Grada 2010: s. 429-437.
13. Niederle B., Roka, R., Woloszczuk, W., Schernthaner, G. et al. Epidemiologische Untersuchungen zum primaren Hyperparathyreoidismus. Eine prospective Multizenterstudie. Dtsch. med. Wochenschr. 1988, 113(5), s. 163-168.
14. Yu, N., Donnan, P.T., Murphy, M.J., Leese, G.P. Epidemiology of primary hyperparathyroidism in Tayside, Scotland, UK. Clin. Endocrinol. 2009, 71(4), p. 485-493.
15. Peacock, M., Bolognese, M.A., Borofsky, M. et al. Cinacalcet treatment of primary hyperparathyroidism: biochemical and bone densitometric outcomes in a five-year study.
J. Clin. Endocrinol. Metab. 2009; (94)12, p. 4860-4867.
16. Rusterholz, D., Miller, W. Surgical therapy concept in primary hyperparahyroidism. Schweiz Med. Wochenschr. Suppl 2000, 116, p. 62S-65S.
17. Sinha. S,. Sinha, A., McPherson, G.A. Synchronous sporadic carcinoma and primary hyperplasia of the parathyroid glands: A case report and review of the literature. Int. J. Surg. Pathol. 2006,14(4), p. 336-339.
18. Thorhallsdottir, H., Asgeirsson, K.S., Olafsdottir, A., Gudbjartsson, T. Primary hyperparathyroidism due to an intrathoracic parathyroid adenoma. Laeknabladid 2010, 96(7), p. 469.
19. Vaid, S., Pandelidis, S. Minimally invasive parathyroidectomy: a community hospital experience. Arch. Surg., 2011, 146(7), p. 876-878.
20. Zadák, Z., Havel, E. a kol. Intenzivní medicína na principech vnitřního lékařství. 1. vyd Praha: Grada 2007, s. 109-111.
Labels
General practitioner for children and adolescents General practitioner for adultsArticle was published in
General Practitioner
2011 Issue 10
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