Primary hyperparathyroidism and parathyroid cancer. Report of one caseWe report a 51 years old female operated for a primary hyperparathyroidism that relapsed in two occasions. After the fi rst and second operation, the pathological study of the excised glands disclosed an adenoma. After the second relapse, a parathyroid gland in the right lateral and upper cervical region, located with technetium (Tc)-99m Sestamibi scintigraphy, was excised. The pathological study of the surgical piece disclosed a parathyroid carcinoma without local lymph node involvement. A postoperative 18F-fl uorodexyglucose positron emission tomography did not show tumor dissemination.Key words: Hyperparathyroidism, parathyroid cancer, parathyroid adenoma.
ResumenPresentamos un caso de sexo femenino, operada por hiperparatiroidismo primario, con 2 recidivas posteriores. En las 2 primeras oportunidades, el diagnóstico histológico fue compatible con adenoma. La última intervención se debió realizar por una glándula ubicada, de acuerdo al Sestamibi Tc-99m, en la región cervical lateral alta derecha. Se realizó exploración supraomohiodea, efectuando la extirpación de la glándula y adenopatías peritumorales. La biopsia defi nitiva informó carcinoma de paratiroides y ganglios linfáticos negativos para neoplasia. Se realizó estudio de diseminación y PET-FDG de control en el postoperatorio alejado, sin nuevos hallazgos. Entre la primera y la segunda intervención, se realizó una tiroidectomía total por un bocio uninodular, cuya biopsia informó 3 paratiroides normotípicas, intratiroideas. En suma, se lograron identifi car histológicamente 6 glándulas paratiroides.
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