Klinicist (Jul 2018)
CLINICAL CASE OF GIANT ADENOMA OF PARATHYROID GLAND
Abstract
Objective: to analyse and provide a description of the clinical case of a giant parathyroid adenoma, to show the fetures of clinical course, diagnosis, the results of surgical treatment and tactics of conducting in the postoperative period. Materials and methods. Patient S., aged 60, with a 10-year history of severe osteoporosis with fractures, urolithiasis, hypertension, low back pain, was consulted by a rheumatologist. In respect that there was the combination of severe osteoporosis with nephrolithiasis and elevated serum calcium level, the patient was directed to a consultation with the endocrinologist and was hospitalized in the city endocrinology department.Results. When examining in the endocrinology department, violations of phosphorus-calcium metabolism, an increase in parathyroid hormone, characteristic of hyperparathyroidism of bone skeleton changes were revealed. Based on the results of ultrasound and magnetic resonance imaging of the neck, neoplasm of the lower parathyroid gland was revealed on the left side. A puncture biopsy and surgical treatment was performed. A dense tumor of dark color, 45 × 30 × 20 mm in size, was removed, according to a histological study – a mixed-cell adenoma with cellular polymorphism. The early postoperative period was complicated by the development of hypoparathyroidism that was corrected by taking calcium and cholecalciferol preparations. In the future, the condition stabilized, a partial regression of the symptoms of hyperparathyroidism was observed.Сonclusion. In this clinical case, features of the clinical course of parathyroid adenoma of large size, the role of interdisciplinary interaction in diagnosis, the results of surgical treatment and the difficulties of postoperative management are presented.
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