gms | German Medical Science

The aim of this paper is presentation of diagnosis and treatment of primary parathyroid adenoma on the basis of 5 patients treated in our institution. Four women at the age of 20 – 45 years presented to orthopedic clinic because of recurrent bone fractures. Conventional x-rays of skull and long bones revealed osteodystrophic lesions. Sonography B and computed tomography of the neck demonstrated well delineated tumor near the thyroid gland. MIDI scintigraphy showed the lesion to be parathyroid adenoma. All the patients had elevated serum calcium and parathormon level.

Surgery revealed in two patients tumor of 3x2 cm diameter arising from lower parathyroid gland. Two patients had tumor of 2 cm diameter originating from upper parathyroid gland. The recurrent laryngeal nerve was identified and dissected. The inferior thyroid artery was also preserved. Postoperative course was uneventful apart one patient who had temporary vocal cord palsy. Pathology report confirmed diagnosis of parathyroid adenoma. In one patient another parathyroid adenoma was diagnosed on the opposite site of the neck a year later and it was also removed. Serum parathormon slowly normalized and bone lesions improved.