RESUMO
Primary hyperparathyroidism (PHPT) is the most prevalent cause of hypercalcemia, affecting 0.3% of the population. The only curative procedure is parathyroidectomy. Persistent PHPT occurs in 4.7 percent of patients, even in the most skilled hands. Ectopic adenomas are challenging to localize before and during surgery and frequently result in persistent PHPT. We presented a case with persistent PHPT due to lung parathyroid adenoma that was successfully resected with video-assisted thoracoscopic surgery. A 55-year-old female patient was admitted to our endocrinology clinic with persistent PHPT after four neck explorations over 16 years. The last 99m Tc-MIBI scintigraphy with SPECT showed nothing suggestive of parathyroid adenoma, neither in the neck nor the mediastinum, but a solitary nodule as an incidental finding was reported in the lower lobe of the right lung, which was highly probable for a parathyroid adenoma in a fluorodeoxyglucose PET scan. Pathological examination ruled out parathyromatosis and lung malignancy; despite its location outside the anticipated embryonic pathway, pathology revealed the presence of an ectopic parathyroid adenoma. After the surgery, serum parathyroid hormone and calcium levels decreased, and hypoparathyroidism was corrected with calcium carbonate and calcitriol.
Assuntos
Adenoma , Hiperparatireoidismo , Neoplasias das Paratireoides , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias das Paratireoides/complicações , Neoplasias das Paratireoides/diagnóstico por imagem , Neoplasias das Paratireoides/cirurgia , Glândulas Paratireoides/diagnóstico por imagem , Glândulas Paratireoides/cirurgia , Tecnécio Tc 99m Sestamibi , Adenoma/complicações , Adenoma/diagnóstico por imagem , Adenoma/cirurgia , PulmãoRESUMO
BACKGROUND: Thyroid hemiagenesis is a rare congenital anomaly in which 1 thyroid lobe fails to develop. Co-occurrence of hemiagenesis and thyroid carcinoma is extremely rare. Here, we report 2 cases of thyroid hemiagenesis with carcinoma. METHODS: The first patient was referred with a left thyroid mass and absent right lobe. The frozen section examination revealed medullary thyroid carcinoma (MTC); therefore, a left thyroid lobectomy plus neck dissection was performed. Another patient was referred with a right thyroid mass and absent left lobe. Fine-needle aspiration biopsy was suspicious for papillary carcinoma. The patient underwent right thyroid lobectomy plus neck dissection. RESULTS: The operative findings confirmed hemiagenesis of the right lobe and MTC in the left lobe for the first case, and hemiagenesis of the left lobe and papillary carcinoma in the right lobe for the second case. CONCLUSION: Our case represents the first reported case of association between thyroid hemiagenesis and MTC.
Assuntos
Carcinoma Papilar/patologia , Glândula Tireoide/anormalidades , Neoplasias da Glândula Tireoide/patologia , Tireoidectomia/métodos , Biópsia por Agulha Fina , Carcinoma Neuroendócrino , Carcinoma Papilar/diagnóstico , Carcinoma Papilar/cirurgia , Feminino , Seguimentos , Humanos , Imuno-Histoquímica , Pessoa de Meia-Idade , Esvaziamento Cervical , Doenças Raras , Medição de Risco , Glândula Tireoide/patologia , Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/cirurgia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento , Ultrassonografia DopplerRESUMO
A knowledge of the embryology and descent of the testes is essential for all clinicians. Congenital hydrocoele, though an embryologic anomaly can present in adulthood. A abdomino scrotal hydrocole must be considered when a mass in the lower abdomen co exists with a scrotal hydrocoele.
El conocimiento de la embriología y el descenso de los testículos es esencial para todos los clínicos. El hidrocele congénito, aunque es una anomalía embriológica se puede presentar en la edad adulta. Un hidrocele abdomino-escrotal debe ser considerado cuando una masa en la parte inferior del abdomen co existe con un hidrocele testicular.
