RESUMEN
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.
Asunto(s)
Femenino , Humanos , Persona de Mediana Edad , Calcio , Sangre , Hipercalcemia , Hiperparatiroidismo , Diagnóstico , Hipocalcemia , Quimioterapia , Neoplasias del Mediastino , Diagnóstico , Diagnóstico por Imagen , Cirugía General , Glándulas Paratiroides , Patología , Neoplasias de las Paratiroides , Diagnóstico , Diagnóstico por Imagen , Cirugía General , Complicaciones Posoperatorias , Tecnecio Tc 99m Sestamibi , Farmacología , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
Blood copper, zinc, magnesium and lead levels were determined by atomic absorption spectroscopy for 15 males and 16 females suffering from depression, 6 males and 1 female with mental retardation and 3 males and 4 females with seizure disorders. They were all under no medication and belonged to low income groups. No difference in copper levels was found between the sexes in any of the groups. The levels in all the groups were significantly higher than in the normals. In depressives, males had significantly higher zinc levels than females and only female depressives had significantly different [lower] levels from normals. In both depressives and normals, males had higher magnesium levels than females but no group of patients had significantly different levels from normals. Lead levels were significantly higher in female depressives and for those with seizure disorders than for controls. At least one metal abnormality was found in 21 [67.7%] depressive, 5 [71.4%] of those with mental retardation and 6 [85.7%] with seizure disorders