Other
Intraoperative parathyroid hormone measurements in a female with parathyroid adenoma
Ljiljana Mayer
; Department of Biochemistry, University Hospital for Tumors, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Mihaela Gaće
; Department of Biochemistry, University Hospital for Tumors, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Sanja Dobrijević
; Department of Biochemistry, University Hospital for Tumors, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Zvjezdana Špacir-Prskalo
; Department of Biochemistry, University Hospital for Tumors, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Renato Janušić
; Department of Head and Neck Surgery, University Hospital for Tumors, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Vesna Ramljak
; Department of Cytology, University Hospital for Tumors, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Fabijan Knežević
; Department of Pathology, University Hospital for Tumors, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
Abstract
Primary hyperparathyroidism (PHPT) is a disorder characterized by increased and uncontrolled parathyroid hormone secretion, a cause of hyperfunction of one or more parathyroid glands. In 80-85% of cases PHPT is caused by parathyroid adenoma. Persistent hyperparathyroidism leads to altered osseous metabolism involving bone resorption and tissue changes. In rare cases, approximately in every thirteenth patient with PHPT, the bone mass is suspected of being a neoplastic lesion – a so-called brown tumor induced by primary hyperparathyroidism. The only way of PHPT correction is a surgical removal of the hyperactive parathyroid glands. In this article we report the first case of intraoperative parathyroid hormone measurements for primary hyperparathyroidism in the Republic of Croatia. The possibility of intraoperative PTH monitoring provides extra safety for both the patient and the operator. Intraoperative PTH becomes an exact instructor (navigator) to the operator – surgeon. Based on the decreasing value of this peptide with a very short half-life, the surgeon makes immediate decision if the operation is completed or further excision of the parathyroid glands is required because of hyperplasia. A guarantee for successful diagnosis, which is a prerequisite for a correct treatment, is a multidisciplinary, continuous, systematic and synchronized cooperation of the whole and heterogeneous medical team, which includes clinicians, radiologists, cytologists, pathologists and medical biochemists.
Keywords
primary hyperparathyroidism; intraoperative PTH; hypercalcemia; brown tumor
Hrčak ID:
277472
URI
Publication date:
30.11.2011.
Visits: 430 *