Giant Parathroid Adenoma With Thoracic Extension: A Case Report

Hejer Mbarek*, Hadhemi Belaid, Khaled Khamassi, Ines Riahi, Habib Jaafoura, Sondes Mannoubi, Rim Lahiani and Mamia Ben Salah

Giant Parathroid Adenoma With Thoracic Extension: A Case Report.

The physical examination results were normal. The technetium sestamibi parathyroid scintigraphy showed a large fixation area next to the inferior pole of the left lobe of the thyroid.

Cervical computed tomography scan showed a 6 cm tissue lesion in the inferior pole of the thyroid’s left lobe. The patient was operated through a classical cervical incision, extracting successfully a 6 cm brown lesion. The histopathological study has confirmed the diagnosis of a giant parathyroid adenoma weighing 84 g.

Giant parathyroid adenoma is an extremely rare entity, especially in developed countries, with sporadic reports of masses
attaining 70 g or more. The surgical management is a challenge.

The physical examination results were normal. Blood tests showed that the PTH was twice the normal level and the renal function was normal. The technetium sestamibi parathyroid scintigraphy showed a large fixation area next to the inferior pole of the left lobe of the thyroid, related to a huge parathyroid adenoma.

Cervical computed tomography scan showed a 6 cm tissue lesion in the inferior pole of the thyroid’s left lobe, repressing backward the subclavian artery, and forward the common carotid artery. This lesion circumvents the left common carotid artery reaching the mediastinum orifice.

The patient was operated by a classical cervical incision, extracting successfully a 6 cm brown lesion next to the inferior pole of the left thyroid lobe. Intra-operative PTH test confirmed the total resection of parathyroid adenoma.

In post-operative period, our patient had neither dysphonia nor paresthesia. Blood test control showed the normalization of the PTH and calcemia levels.

 

Otolaryngol Open J. 2018; 4(1): 6-8. doi: 10.17140/OTLOJ-4-145

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