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Related Experiment Videos

Ectopic primary hyperparathyroidism.

M T Saky1, S Hasinski, L I Rose

  • 1Division of Endocrinology and Metabolism, Department of Medicine, MCP Hahnemann University Hospital, Philadelphia, Pennsylvania 19102, USA.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
|August 11, 2001
PubMed
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Ectopic parathyroid adenomas can cause persistent hypercalcemia when standard imaging and neck surgery fail. Extended imaging and selective venous sampling helped locate and treat an unusual diaphragmatic parathyroid adenoma.

Area of Science:

  • Endocrinology
  • Surgical Pathology

Background:

  • Primary hyperparathyroidism is typically caused by parathyroid adenomas in the neck.
  • Ectopic parathyroid adenomas are rare but can present diagnostic challenges.

Observation:

  • A 74-year-old woman presented with persistent hypercalcemia.
  • Standard neck imaging (99mTc sestamibi scan) and surgical exploration of the neck were unsuccessful in locating the adenoma.
  • The patient had undergone removal of three parathyroid glands without resolution.

Findings:

  • An extended-field 99mTc sestamibi scan identified an ectopic parathyroid adenoma in the right diaphragm region.
  • Selective venous sampling and angiography confirmed the adenoma's location.
  • Embolization of the ectopic adenoma resolved the patient's hypercalcemia.

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Implications:

  • Ectopic parathyroid lesions should be considered in cases of persistent hypercalcemia when standard investigations are negative.
  • Advanced imaging and invasive localization techniques are crucial for diagnosing and managing ectopic parathyroid adenomas.
  • Successful treatment of ectopic parathyroid adenomas can be achieved through targeted interventions like embolization.