A Case Of Primary Hyperparathyroidism Due To Anterior Mediastinum Located Ectopic ParathyroidAadenoma

Öz

Purpose: Ectopically located parathyroid adenomas are seen in 5-10% of the

patients and these are located in thymus and in the mediastinum with the rates of

95% and 5%, subsequently. Here, we aimed at presenting a patient with an anterior

mediastinum located parathyroid adenoma that was admitted with primary

hyperparathyroidism.

Case report: In the blood serum analysis of the 46 years old female patient;

calcium (Ca+) level was defined as 11,6 mg/dl (8.5-11.0), phosphorus level as 1,4

mg/dl (2.8-5.0), 25-OH vitamin D level as 4,5 ng/ml and parathyroid hormone (PTH)

level was as 696 pg/ml (12-72).

In addition, on parathyroid scintigraphy there was an intense activity

involvement on the anterior midline mediastinal region and on computerized

tomography; a 28 mm sized ectopic parathyroid gland at the same location was

reported. An endoscopic surgery was performed and the thymus and parathyroid

adenoma were removed out of the sternum (ectopic parathyroidectomy with

thymectomy).

Result: The most effective therapy for ectopic parathyroid adenomas is

surgery and although they are seen rarely, it should be kept in mind that parathyroid

glands may be present in ectopic locations. The success of the surgery is mostly

depends on the preoperative localization of this ectopic gland. 

Anahtar Kelimeler

• Primary Hyperparathyroidism, Ectopic Parathyroid Adenoma

Anterior Mediasten Yerleşimli Ektopik Paratiroid Adenomuna Bağlı Primer Hiperparatiroidizm Olgusu

Öz

Amaç: Paratiroid adenomlarının %5-10’u ektopik yerleşimlidir ve sırasıyla %95’i timus içinde, % 5’i ise mediastende lokalizedir. Burada, primer hiperparatiroidi kliniği ile başvurmuş ön mediasten yerleşimli ektopik paratiroid adenomu olan bir olguyu sunmayı amaçladık.

Olgu: Kırkaltı yaşında kadın hastanın yapılan kan tetkiklerinde, kalsiyum: 11,6 mg/dl (8.5-11.0), fosfor: 1,4 mg/dl (2.8-5.0), 25-OH D Vitamin düzeyi 4,5 ng/ml, Parathormon: 696 pg/ml (12-72) saptandı. Ayrıca, hastaya çekilen paratiorid sintigrafisinde; ön mediasten orta hatta paratiroid adenomuyla uyumlu yoğun patolojik aktivite tutulumu ve çekilen toraks BT'sinde aynı lokalizasyonda 28x20 mm boyutlarında ektopik paratiroid adenomu tespit edildi. Tedavi olarak video endoskopik yöntemle paratiroid adenomunun lokalizasyonu tespit edilip, adenom sternum dışına timüs ile birlikte çıkarıldı (Ektopik paratiroidektomi ve timektomi).

Sonuç: Paratiroid adenomlarında cerrahi en etkili tedavi seçeneğidir ve nadir de olsa glandların ektopik yerleşebileceği göz ardı edilmemelidir. Cerrahi başarı ise büyük oranda bezin lokalizasyonunun preoperatif belirlenmesine bağlıdır.

Anahtar Kelimeler

• Primer Hiperparatiroidizm, Ektopik Paratiroid Adenomu

Kaynakça

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