Hiperparatiroidismo primario por adenoma gigante de paratiroides: Abordaje quirúrgico selectivo

Daniel González González; Cecilia Chambón; Gustavo Armand Ugón

doi:10.29193/RMU.37.1.13

Authors

Daniel González González Universidad de la República, Facultad de Medicina, Clínica Quirúrgica 3, Prof. Titular
Cecilia Chambón Universidad de la República, Facultad de Medicina, Clínica Quirúrgica 3, Asistente
Gustavo Armand Ugón Universidad de la República, Facultad de Medicina, Clínica Quirúrgica 3, Prof. Adjunto

DOI:

https://doi.org/10.29193/RMU.37.1.13

Keywords:

PRIMARY HYPERPARATHYROIDISM, PARATHYROID NEOPLASMS, GIANT PARATHYROID ADENOMA, PARATHYROIDECTOMY

Abstract

Introduction: primary hyperparathyroidism caused by giant parathyroid adenoma is a rather unusual condition. Reported large adenomas occurred in ectopic parathyroid glands (mediastinal). Just like carcinomas, they are large, present high calcemia and parathyroid hormone values, what complicates diagnosis. Surgical treatment consists in parathyroidectomy by means of transversal cervicotomy around the infrahyoid region.
Objective: the study presents the clinical case of primary hyperparathyroidism caused by giant parathyroid adenoma that was treated by selective surgery approach.
Clinical case: 53 year-old female patient with a history of uretheral lithiasis, bone pain and 4-cm-diameter infrahyoid tumor. Imagenology studies revealed the characteristics of lower left parathyroid adenoma. Functional assessment confirmed hyperparathyroidism.
Upon the diagnosis of primary hyperparathyroidism caused by giant parathyroid adenoma it was surgically addressed by means of a small cut around the tumour and performing a lower left parathyroidectomy, what resulted in the remission of symptoms and normalized parathyroid functionality.
Discussion: primary hyperparathyroidism caused by giant parathyroid adenoma has an indication for surgery and is therapeutic. The case presented shows the feasibility and safety of a selective approach, as well as its smaller cosmetic harm, managing to keep the contralateral thyroid loggia intact, in view of future surgeries involving it.

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