Paratiroid adenomunu taklit eden paratiroid karsinomu olgusu

Öz

Paratiroid karsinomu nadir görülen endokrin tümörlerden biri olup primer hiperparatiroidizmli olgularının %1'ini oluşturmaktadır. Benzer görüntüleme yöntemleri ve benzer klinik bulgular nedeniyle preoperatif paratiroid adenomları ve paratiroid karsinomu ayırt etmek zordur. 70 yaşında kadın hasta, yorgunluk ve yaygın kemik ağrısı şikayeti ile başvurdu. Laboratuvar testleri, artmış parathormon düzeyi, boyun ultrasonografisi ve paratiroid sintigrafisi, primer hiperparatiroidizm ile uyumluydu. Paratiroid adenomunu destekleyen görüntüleme yöntemleri ile hasta paratiroid adenomuna bağlı primer hiperparatiroidi ön tanısı ile opere edildi. Ameliyat sonrası problem saptanmayan hasta, postoperatif beşinci günde sorunsuz bir şekilde taburcu edildi. Postoperatif patoloji paratiroid adenomunda gelişen paratiroid karsinomu olarak rapor edildi. Paratiroid karsinomu ve paratiroid adenomu benzer klinik ve görüntüleme yöntemlerine sahiptir, preoperatif tanı koymak zordur.

Anahtar Kelimeler

• Hiperkalsemi,Primer hiperparatiroidizm,Paratiroid adenomu,Paratiroid karsinomu

A case of parathyroid carcinoma mimicking parathyroid adenoma

Abstract

Parathyroid carcinoma is one of the rare endocrine tumors and constitutes 1% of the cases with primary hyperparathyroidism. Because of similar imaging modalities and similar clinical findings, it is difficult to distinguish between preoperative parathyroid adenomas and parathyroid carcinoma. A 70-year-old female patient presented with fatigue and generalized bone pain. Her laboratory tests, neck and parathyroid scintigraphy were compatible with primary hyperparathyroidism with a significantly elevated level of parathormone. With the imaging methods which supported parathyroid adenoma, the patient was operated with a presumptive diagnosis of primary hyperparathyroidism due to parathyroid adenoma. The postoperative course was unremarkable and she was discharged on the postoperative fifth day. Postoperative pathology was reported as parathyroid carcinoma developed in a parathyroid adenoma. Parathyroid carcinoma and parathyroid adenoma have similar clinically and imaging methods, it is difficult to diagnose preoperatively.

Keywords

• Hypercalcemia,Primary hyperparathyroidism,Parathyroid adenoma,Parathyroid carcinoma

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