Hyperparathyroidism related to an ectopic parathyroid adenoma

Attifi Hicham, Messary Abdelhamid

PAMJ. 2014; 19:135. Published 08 Oct 2014 | doi:10.11604/pamj.2014.19.135.4931

A 46-year-old female with a history of muscle weakness, nephrolithiasis and peptic ulcer. He 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.
Corresponding author
Attifi Hicham, Department of UNT, Military Hospital Moulay Ismail, Meknes, Morocco (hichamattifi76@gmail.com)


The Pan African Medical Journal (ISSN: 1937-8688) is a subsidiary of the Pan African Medical Journal. The contents of this journal is intended exclusively for professionals in the medical, paramedical and public health and other health sectors.

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