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Related Experiment Videos

Multiple ectopic parathyroid adenomas.

Rogério Aparecido Dedivitis1, André Vicente Guimarães, Gustavo Bastos de Goes Pontes

  • 1Department of Otorhinolaryngology, Head and Neck Surgery of Universidade Metropolitana de Santos (Unimes), Hospital Ana Costa, Santos, São Paulo, Brazil. dedivitis.hns@uol.com.br

Sao Paulo Medical Journal = Revista Paulista De Medicina
|May 27, 2004
PubMed
Summary

Primary hyperparathyroidism, a common cause of hypercalcemia, can involve rare ectopic glands. This case highlights successful surgical localization and removal of double parathyroid adenomas, improving patient outcomes.

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Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Medical Imaging

Background:

  • Primary hyperparathyroidism is the leading cause of hypercalcemia.
  • Ectopic parathyroid gland locations are crucial for surgical planning and avoiding re-operation.
  • Multiple ectopic glands pose significant challenges in parathyroid surgery.

Observation:

  • A 65-year-old female with nephrolithiasis and elevated calcium presented with primary hyperparathyroidism.
  • Ultrasound and Technetium sestamibi scanning identified one adenoma and suggested a contralateral ectopic gland.
  • Fiber optic laryngoscopy and resonance imaging revealed an extrinsic mass in the pyriform sinus.

Findings:

  • Bilateral neck exploration successfully identified and removed double parathyroid adenomas.

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  • Histopathological examination confirmed the diagnosis of parathyroid double adenomas.
  • Postoperative follow-up revealed normal serum calcium and parathyroid hormone levels.

    • Implications:

    • Routine bilateral neck exploration is recommended for primary hyperparathyroidism.
    • Preoperative localization using ultrasound and Technetium sestamibi scanning is valuable.
    • Surgeon experience is critical for successful localization and management of ectopic parathyroid glands.