Anterior mediasten yerleşimli paratiroid adenomu

Öz

Primer hiperparatroidizme sebep olan paratroid lezyonlarının gerçek insidansı belirsizdir. Olguların en sık nedenini %75-80 adenomlar oluşturmaktadır. Benign hiperplaziler %10-15’inde, paratroid karsinomları ise %5’den azında sorumludurlar. Hiperparatroidizme neden olan paratroid adenomlarının %20-25’i ektopik yerleşimlidir. Biz bu olgu sunumunda anterior mediastende yer alan ektopik paratroid adenomu nedeniyle semptomatik hiperkalsemili olguyu tartıştık. Olguya mediyan sternotomi aracılığıyla timektomi ile ektopik paratroid rezeksiyonu uygulandı. Serum kalsiyum ve parathormon seviyeleri hızlı bir biçimde geriledi.

Anahtar Kelimeler: Ektopik, Paratroid, Primer, Hiperparatroidizm

Anahtar Kelimeler

• Paratroid hastalıkları, ektopik, primer hiperparatroidizm, mediasten

Parathyroid adenoma located on anterior mediastinum

Öz

The real incidence of parathyroid lesions causing primary hyperparathyroidism is unclear. Adenomas are the most common cause constitute 75-80 % of the cases. Benign hyperplasia responsible for 10-15%, and the parathyroid carcinoma less than 5%. Parathyroid adenomas causing to hyperparathyroidism may present an ectopic localization at 20-25% of the patients. Here we discuss a case of symptomatic hypercalcemia, due to an ectopic parathyroid adenoma in the anterior mediastinum. She was treated by ectopic parathyroid removal along with thymectomy, approached by median sternotomy. Serum calcium and parathyroid hormone levels were normalized immediately.

Key Words: Ectopic, Parathyroid, Primary, Hyperparathyroidism

 

 

Kaynakça

1. -Enön S. Mediastenin Endokrin Tümörleri. Toraks Cerrahisi Bülteni. 2011; 2(2):124-35.
2. -Lee WS, Kim YH, Lee SA, Chee HK, Hwang JJ. Hyperparathyroidsm induced by heterotopic parathyroid adenoma in the anterior mediastinum. Turk Gogus Kalp Dama 2014;22(2):443-6.
3. -Çelik A, Aydın E, Yazıcı Ü, Karaoğlanoğlu N. Parathyroid Adenoma Located on Anterior Mediastinum and Hungry Bone Syndrome; Case ReportAnterior. J Clin Anal Med 2014;5(1): 69-71.
4. -Thompson NW, Eckhauser F, Harness J. The anatomy of primary hyperparathyroidism. Surgery 1982;92(5):814-21.
5. -Soler R, Bargiela A, Cordido F, Aguilera C, Argüeso R, Cao I. MRI of mediastinal parathyroid cystic adenoma causing hyperparathyroidism. J Comput Assist Tomogr 1996;20:166-8.
6. -Uludag M, Isgor A, Yetkin G, Atay M, Kebudi A, Akgun I. Supernumerary ectopic parathyroid glands. Persistent hyperparathyroidism due to mediastinal parathyroid adenoma localized by preoperative single photon emission computed tomography and intraoperative gamma probe application. Hormones (Athens) 2009;8:144-9.
7. -Moriyama T, Kageyama K, Nigawara T, et al. Diagnosis of a case of ectopic parathyroid adenoma on the early image of 99mTc- MIBI scintigram. Endocr J 2007;54(3):437-40.
8. -Uludag M, Isgor A, Yetkin G, Atay M, Kebudi A, Akgun I. Supernumerary ectopic parathyroid glands. Persistent hyperparathyroidism due to mediastinal parathyroid adenoma localized by preoperative single photon emission computed tomography and intraoperative gamma probe application. Hormones (Athens) 2009;8(2):144-9.

9. -Al-Mashat F, Sibiany A, Faleh D, Kary K, Alfi AY, El-Lakany MM. Mediastinal para-thyroid adenoma. Saudi J Kidney Dis Transpl 2009;20(5):826-30.
10. -Johnson NA, Tublin ME, Ogilvie JB. Parathyroid imaging: technique and role in the preoperative evaluation of primary hyperparathyroidism. AJR Am J Roentgenol 2007;188(6):1706-15.
11. -Tcherveniakov P, Menon A, Milton R, Papagiannopoulos K, Lansdown M, Thorpe JA. Video-assisted mediastinoscopy (VAM) for surgical resection of ectopic parathyroid adenoma. J Cardiothorac Surg 2007;2:41.