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ISSN 1405-0099 (Print)

2001, Number 2

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Cir Gen 2001; 23 (2)

Resection of a retrosternal ectopic parathyroid adenoma using a radioguided minimally invasive technique. Report on one patient

Cervantes CJ, Rojas RG, García OR, Baquera HJ, Ortiz HC, Manzano AF, Lezama RMA

Language: Spanish
References: 16
Page: 105-108
PDF size: 64.17 Kb.


ABSTRACT

Purpose: To inform on the use of the Gamma probe to help localize and resect, utilizing minimally invasive techniques, an ectopic parathyroid adenoma located in the anterior-superior mediastinum.
Setting: Third level care Hospital
Description of the case: A 75 years old female consulted because vague symptoms, the physical examination was normal. Multiple laboratory tests were normal, except for serum calcium of 13.1 mg (normal 8.5 to 10 mg) and phosphorus 1.8 mg (normal of 2.5 to 4.6 mg); serum paratohormone (PHT) revealed elevated values: 121 pg/ml (normal 10 to 65), PTHC-Terminal of 815 pg/ml (normal 70 to 270). The nuclear medicine study showed an area of anomalous concentration of the radio-tracer at the anterior-superior mediastinum. CT Scan of the neck was normal, CT Scan of the thorax confirmed the presence of a possible adenoma at the anterior-superior mediastinum. The Gamma probe detector (Neoprobe 2000) helped to locate the adenoma, which was attached to the upper left horn of the thymus gland and measured 2 cm. The tumor was resected by means of a 3 cm cervical incision in 30 minutes, the patient left the Hospital 20 horus later. During the immediate postoperative period, the PTH decreased to 31 pg/ml and serum calcium to 10.1 mg. Three weeks after surgery, calcium and phosphorus values were of 9.4 mg and 3.4 mg, respectively. The pathology study reported a parathyroid adenoma without evidence of malignancy and three lymph nodes with sinusoidal hyperplasia.
Conclusion: The minimally invasive approach in primary hyperparathyroidism with the help of the Gamma probe to localize the adenoma is a safe surgical procedure.


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