Endocrine Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia.
Singapore Med J. 2011 Apr;52(4):e70-4.
Primary hyperparathyroidism due to ectopic parathyroid adenomas can pose diagnostic and management challenges, especially when imaging studies have localised the lesions to different sites. We report a case of symptomatic hypercalcaemia due to a mediastinal parathyroid adenoma. Ultrasonography identified a nodule posterior to the right thyroid gland. However, computed tomography and technetium-99m sestamibi scintigraphy revealed an ectopic parathyroid adenoma located in the anterior mediastinum. The adenoma was successfully removed through a median sternotomy. However, postoperatively, the patient developed prolonged symptomatic hypocalcaemia, possibly due to suppression of the normal parathyroid gland function, although the presence of concomitant hungry bone syndrome was possible. The histopathology of the mediastinal mass was consistent with a parathyroid adenoma.
原发性甲状旁腺功能亢进症由异位甲状旁腺腺瘤引起，可能会带来诊断和治疗方面的挑战，尤其是当影像学研究将病变定位在不同部位时。我们报告了一例由纵隔甲状旁腺腺瘤引起的有症状高钙血症病例。超声检查发现右侧甲状腺后有一个结节。然而，计算机断层扫描和锝-99m sestamibi 闪烁显像显示异位甲状旁腺腺瘤位于前纵隔。通过正中胸骨切开术成功切除了腺瘤。然而，术后患者出现了长时间的有症状低钙血症，可能是由于正常甲状旁腺功能受到抑制，尽管同时存在饥饿骨综合征也是可能的。纵隔肿块的组织病理学检查与甲状旁腺腺瘤一致。
