Beklenmedik Bir Yerleşim Gösteren Ektopik Paratiroid Adenom Olgusu
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Tarih
2015
Yazarlar
Dergi Başlığı
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Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Ektopik paratiroid dokusu mandibuladan mediastene kadar herhangi bir lokalizasyonda görülebilir. Paratiroid cerrahisinde asıl sorun bahsi geçen ektopik paratiroid dokularının lokalizasyonunun belirlenmesi ve rezeksiyonudur. Hiperparatiroidisi olan hastaların %1-2'sinde derin mediastinal yerleşimli paratiroid olmakta ve çoğu zaman transsternal ya da transtorasik yaklaşım gereksinimi ortaya çıkabilmektedir. Yaklaşık 1 yıldır devam eden yaygın eklem ağrısı ve halsizlik şikayeti ile başvuran 63 yaşında bayan hastada, kalsiyum ve parathormon yüksekliği saptanması üzerine yapılan tetkikler neticesinde mediastinal bölgede paratiroid adenomu saptandı. Bu nedenle servikal kesi ile yapılan ameliyatta üst mediastende, karotis arter kılıfı içerisinde, posterior lokalizasyonda yerleşmiş adenom tespit edildi ve sağlam cerrahi sınırla beraber çıkarıldı. Ameliyat sonrasında kalsiyum, fosfor ve parathormon seviyeleri normale dönen hasta 2. gün sorunsuz taburcu edildi. Sonuç olarak paratiroid, atipik yerleşimi oldukça sık görülebilen bir dokudur. Buna rağmen, atipik yerleşimli paratiroid cerrahisi tecrübeli ellerde, işlem öncesinde ve/veya esnasında yapılacak lokalizsyon çalışmalarının da katkısı ile ikincil bir cerrahiye ihtiyaç bırakmadan, minimal invazif yöntemlerle başarılı bir şekilde yapılabilmektedir.
Ectopic parathyroid tissue can be seen at any location from the mandibula to the mediastinum. The main problem in parathyroid surgery are determination of these ectopic parathyroid tissues' location and their resection. About 1-2% of patients with hyperparathyroidism have a deep mediastinal located parathyroid and transsternal or transthoracic approach should have to be employed most of the time. A 63-year-old female patient, presenting with widespread joint pain and fatigue complaints going on for about a year, was diagnosed with parathyroid adenoma in the mediastinal area as shown by the results of analyses conducted upon the detection of high levels of calcium and parathormone. Accordingly she was taken into surgery with a cervical incision and adenoma in a posterior localization in the carotid artery sheath on the upper mediastinum was seen. The patient, whose calcium, phosphor, and parathormone levels returned to normal levels following the surgery, was discharged with no problems on post-op day 2. Consequently, parathyroid is a tissue whose atypical localization is quite frequent. Nevertheless, atypical localized parathyroid surgeries can be performed by experienced surgeons without having to resort to a secondary procedure with minimally invasive methods with the contribution of localization studies before and/or during the procedure.
Ectopic parathyroid tissue can be seen at any location from the mandibula to the mediastinum. The main problem in parathyroid surgery are determination of these ectopic parathyroid tissues' location and their resection. About 1-2% of patients with hyperparathyroidism have a deep mediastinal located parathyroid and transsternal or transthoracic approach should have to be employed most of the time. A 63-year-old female patient, presenting with widespread joint pain and fatigue complaints going on for about a year, was diagnosed with parathyroid adenoma in the mediastinal area as shown by the results of analyses conducted upon the detection of high levels of calcium and parathormone. Accordingly she was taken into surgery with a cervical incision and adenoma in a posterior localization in the carotid artery sheath on the upper mediastinum was seen. The patient, whose calcium, phosphor, and parathormone levels returned to normal levels following the surgery, was discharged with no problems on post-op day 2. Consequently, parathyroid is a tissue whose atypical localization is quite frequent. Nevertheless, atypical localized parathyroid surgeries can be performed by experienced surgeons without having to resort to a secondary procedure with minimally invasive methods with the contribution of localization studies before and/or during the procedure.
Açıklama
Anahtar Kelimeler
Adenoma, Ectopic, Parathyroid, Adenom, Ektopik, Paratiroid
Kaynak
Çukurova Üniversitesi Tıp Fakültesi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
40
Sayı
Ek 1
Künye
Erikoğlu, M., Taşcı, H. İ. (2015). Beklenmedik bir yerleşim gösteren ektopik paratiroid adenom olgusu. Çukurova Üniversitesi Tıp Fakültesi Dergisi, 40, Ek 1, 127-130.
