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- Title
ECTOPIC PARATHYROID ADENOMA LOCATED IN THE ANTERIOR MEDIASTINUM, INSIDE THE THYMUS, DETECTED BY GAMMA PROBE.
- Authors
Daliakopoulos, Stavros; Patelidoy, Barbara; Chatzoulis, George; Ioannidis, Costantinos; Lampridis, Savvas; Vrekas, Christos; Spyridopoulos, Panagiotis
- Abstract
PURPOSE: Primary hyperparathyroidism due to parathyroid adenomas may be associated with an ectopic parathyroid localization in 20-25% of the patients. Between 11% and 22% of patients with primary hyperparathyroidism are estimated to have mediastinal adenomas. Most of them are found in close proximity to the thymus, with the inferior parathyroid glands originating from the third bronchial pouch with the thymus. MATERIAL‟s-METHOD‟s: A 38-year-old patient presented to our clinic with a history of bilateral nephrolithiasis, chronic hypercalcemia and PTH elevation. The use for the concordance of at least two diagnostic modalities before surgical excision minimizes the risk of re-operation for recurrent hyperparathyroidism. The combination of 99mTc sestamibi scintigraphy and CT scan of the chest and neck gave important preoperative information in our case, proceeding to a successful surgical exploration. We also used intraoperative gamma probe which offers a significant advantage over conventional techniques by reducing surgical time, morbidity and/or complications associated with surgical exploration. RESULTS: An ectopic parathyroid adenoma 8.5 mm in its greatest dimension was detected preoperatively. Intraoperatively, the patient underwent sternotomy and after the use of γ-probe adenoma the adenoma was identified inside the right lobe of the thymus gland. Intraoperative PTH detection and frozen biopsy confirmed the successful excision of the adenoma, while mild postoperative hypocalcemia was noticed. CONCLUSION: Accurate preoperative and intraoperative localization of ectopic parathyroid adenoma is crucial to successful surgery.
- Publication
Balkan Military Medical Review, 2013, Vol 16, p124
- ISSN
1107-6275
- Publication type
Article