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Atipik yerleşimli paratiroid adenomunun gama probe ile tespiti: olgu sunumu

Journal Name:

  • Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi

Publication Year:

  • 2007

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
İn patient s who were candidates of parathyroidectomy, Technetium-99m- hexakis-2-methoxy-isobutyl-isonitrile parathyroid scintigraphy could be used for localization of pathologic parathyroid, and also pathologic areas, could be detected easily using gamma probe during operation. We reported using gamma probe in a persistent primary hyperparathyroidy patient identified a fifth parathyroid gland that localized intrathyroidally. 63-year-old woman operated with the diagnosis of primary hyperparathyroidism. pour parathyroid glands were explorated and first left inferior parathyroid gland that was consisted with parathyroid adenoma was excised. prozen section revealed hyperplasia and other 2.5 parathyroid glands were removed. İn postoperative period parathyroid level did not diminish to normal level and adenoma was seen in scintigraphy. İn second operation fifth parathyroid gland that located intrathyroidally was found by using gamma probe. İn this case the fifth parathyroid gland that could not be detected in conventional method was found easily by using gamma probe in second operation. Using gamma probe in parathyroid surgery is a method that makes the found of both typical and atypical localized adenoma easier and becoming a routine procedure in recent years.
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Abstract (Original Language): 
Paratiroidektomi uygulanması planlanan olgularda Technetium-99m- hexakis-2-methoxy-isobutyl-isonitrile paratiroid sintigrafisi ile patololojik paratiroidlerin yeri saptanabilir ve operasyonda bu odaklar gama probe kullanılarak tespit edilebilir.Bu olguda klasik cerrahi tedavi yöntemi ile bulunamayan tiroid bezi içine yerleşmiş beşinci paratiroid bezi gama probe kullanılarak tespit edildi. 63 yaşındaki bayan hasta paratiroid adenomu ön tanısı ile opere edildi. 4 paratiroid bezi de eksplore edilerek adenom şüphesi olan sol alt paratiroid bezi eksize edildi. "prozen section" incelemesinde paratiroid hiperplazisi tespit edilmesi üzerine kalan bezlere 2,5 paratiroidektomi uygulandı. Ancak hastanın postoperatif takiplerinde parathormon düzeyi yüksek seyretti ve tekrarlanan paratiroid sintigrafisinde sol alt tiroid lojundaki adenom olduğu düşünülen lezyonun sebat ettiği görüldü. İkinci operasyonda gama probe kullanılarak tiroid bezi sol lobu içinde lokalize olmuş beşinci paratiroid bezi bulundu. Bu olguda geleneksel yöntemlerle tespit edilememiş beşinci paratiroid bezi, ikinci ameliyatta gama probe kullanılarak kolaylıkla saptandı. Paratiroid cerrahisinde gama probe kullanımı tipik ve atipik yerleşimli adenomların tespitini kolaylaştıran ve son yıllarda rutin kullanıma giren bir yöntemdir.
FULL TEXT (PDF): 
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  • 4
33-37
  • Turkish

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