Other
https://doi.org/10.21860/medflum2017_173384
Ectopic parathyroid tumor in thorax – case report
Andrej Belančić
; Medicinski fakultet Sveučilišta u Rijeci, Rijeka
Ivana Mikolašević
; Odjel za hepatologiju i pankreatologiju, Klinika za internu medicinu, KBC Rijeka, Rijeka
Melita Kukuljan
; Klinički zavod za radiologiju, KBC Rijeka, Rijeka
Željko Kupanovac
; Zavod za pulmologiju, Klinika za internu medicinu, KBC Rijeka, Rijeka
Igor Saftić
; Odjel za torakalnu kirurgiju, Klinika za kirurgiju, KBC Rijeka, Rijeka
Lidija Orlić
; Zavod za nefrologiju, dijalizu i transplantaciju bubrega, Klinika
Abstract
Introduction: The aim was to present a case of primary hyperparathyroidism due to ectopic parathyroid adenoma localized in thorax. Case report: We report a case of a 64-yearold female patient with hypothyroidism and hypertension in her medical history, presented to us with normocytic anemia, renal insufficiency and dysphagia. Due to swallowing disorder multi-slice computed tomography of thorax was performed and mass in upper-back mediastinum with ossification changes suspicious for metastatic process was found. Within the nephrology examination, hypercalcemia (>3 mmol/L) and elevated parathyroid hormone (PTH) value (200 pmol/L) were noticed, which pointed to the possibility of primary hyperparathyroidism. Consequentially, parathyroid scintigraphy, aspiration biopsy and cytological analysis were performed. Primary hyperparathyroidism was affirmed and ectopic parathyroid adenoma was suggested as possible etiology. The patient has undergone surgical procedure based on thoracotomy with extirpation of the mass. Surgical postoperative course was regular. Postoperative laboratory findings showed hypocalcemia, which was expected due to “hungry bone” syndrome, so medication treatment was necessary. Subsequently, histopathological analysis showed parathyroid tumor with insecure malignant potential. Since metastases were the only satisfied criteria for the malignancy, the diagnosis of parathyroid carcinoma couldn’t be allocated. PTH values after surgery were within the reference range. During a 6-month postoperative follow-up no signs of the disease recurrence were detected. Conclusion: Primary hyperparathyroidism is a very common endocrinology disorder, hence it has to be on a differential diagnosis list in every day clinical practice Except increased parathyroid glands in the typical site in the neck, it is possible to develop ectopic parathyroid glands.
Keywords
ectopic parathyroid glands; parathyroid adenoma; parathyroid carcinoma; primary hyperparathyroidism
Hrčak ID:
173376
URI
Publication date:
1.3.2017.
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