Hyperparathyroidism related to an ectopic parathyroid adenoma
Attifi Hicham, Messary Abdelhamid
The Pan African Medical Journal. 2014;19:135. doi:10.11604/pamj.2014.19.135.4931

Create an account  |  Sign in
Healthcare India 2017 Supplement 2 Supplement
"Better health through knowledge sharing and information dissemination "

Images in medicine

Hyperparathyroidism related to an ectopic parathyroid adenoma

Cite this: The Pan African Medical Journal. 2014;19:135. doi:10.11604/pamj.2014.19.135.4931

Received: 30/06/2014 - Accepted: 27/09/2014 - Published: 08/10/2014

Key words: Hyperparathyroidism, adenoma, hypercalcemia

© Attifi Hicham et al. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Available online at: http://www.panafrican-med-journal.com/content/article/19/135/full

Corresponding author: Attifi Hicham, Department of UNT, Military Hospital Moulay Ismail, Meknes, Morocco (hichamattifi76@gmail.com)


Hyperparathyroidism related to an ectopic parathyroid adenoma

 

Attifi Hicham1,&, Messary Abdelhamid1

 

1Department of UNT, Military Hospital Moulay Ismail, Meknes, Morocco

 

 

&Corresponding author
Attifi Hicham, Department of UNT, Military Hospital Moulay Ismail, Meknes, Morocco

 

 

Image in medicine

A 46-year-old female with a history of muscle weakness, nephrolithiasis and peptic ulcer. She was found to have hypercalcemia (115 mg/l), hypophosphoremia (16 mg/l) and increased PTH serum level (1090 pg/l). In order to discriminate between PH and pseudohyperparathyroidism, a solid-phase, two site chemiluminescent enzyme-labeled immunometric assay directed towards the intact PTH molecule was used and a diagnosis of primary hyperparathyroidism was made. Several studies were performed with the purpose to achieve a pre-operative localization of the oversecreting parathyroid tumor. A cervical sonography showed a normal thyroid gland and no evidence of the tumor was found in the neck. Therefore a 99-TC sesta MIBI was carried out and an accumulation area projected onto the anterior mediastinum was demonstrated (A). Finally a computed tomography scan of the thorax revealed a 4 cm nodule, in the thymic and paratracheal region of the anterior mediastinum (B). The patient underwent surgical resection of the tumor by a lower cervicotomy approach (C,D). Intraoperative parathyroid hormone measurements show a appropriate decrease in PTH levels. A 4x3x2 cm surgical specimen of a parathyroid tissu mass was removed. The anatomopathological examination confirmed the diagnosis of parathyroid adenoma. The post-operative course was uneventful and the patient was discharged in 4th post-operative day with an excellent functional and cosmetic result. A quarterly follow-up was started. PTH serum level and calcemia have been within normal ranges all through 18 months after surgery.

Figure 1: A) a 99-TC sestaMIBI demonstrating an accumulation area projected onto the anterior mediastinum; B) a computed tomography scan of the thorax revealing a 4 cm nodule, in the thymic and paratracheal region of the anterior mediastinum; C) operative view objectifying the resection of the parathyoide adenoma; D) operative view demonstrating the ectopic area of the parathyroid adenoma

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


The Pan African Medical Journal articles are archived on Pubmed Central. Access PAMJ archives on PMC here

Volume 28 (September - December 2017)

Article tools

This article authors

On Pubmed
On Google Scholar

Navigate this article

Rate this article

Altmetric

PAMJ is a member of the Committee on Publication Ethics
Next abstract

PAMJ is published in collaboration with the African Field Epidemiology Network (AFENET)
Currently tracked by: DOAJ, AIM, Google Scholar, AJOL, EBSCO, Scopus, Embase, IC, HINARI, Global Health, PubMed Central, PubMed/Medline, Ulrichsweb, More to come . Member of COPE.

ISSN: 1937-8688. © 2017 - Pan African Medical Journal. All rights reserved