THE DIAGNOSTIC AND IMAGING METHODS IN THE CASES OF PRIMARY HYPERPARATHYROIDISM DUE TO THE SOLITARY ADENOMA

Abstract

In our surgical department 6 cases of parathyroid adenoma were treated surgically. In all cases, diffuse bone, joint and muscle pain were the main locomotor system symptoms. Pathologic fracture, epiphysial slidings, litic lesions and cysts, osteoporotic changes, subperiostal resorption were encountered in the radiologic examination of bones. Diagnosis is made with serum calcium, phosphor, alkaline phosphatase, parathyroid hormone (PTH) levels in blood specimens. Mean serum calcium value is 12.4 mg/dl and PTH value 193 ng/L Ultrasonography (US), Thallium 201-Technetium 99 m substraction scintigraphy, computed tomography (CT) were used for localisation of the scintigraphy, computed tomography (CT) were used for localisation of the adenoma. 3 right inferior, one right superior, one left superior, and one left inferior adenomas were detected previously by imaging modalities. They were correlated exactly with the operative findings. adenomas were totally excised. Postoperative tetany were controlled with calcium lactate. Locomotor system symptoms and findings were improved promptly. There was no recurrence in 0,5-4 years fallow-up. In conclusion the diagnosis of hyperparathyroidism was made by measurements of serum calcium and PTH values. Among the imaging methods ultrasonography and T1 201-Tc 99m substraction scintigraphy were accurate in locating an adenoma.