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YETERSİZ PARATÎROÎDEKTOMÎ SONUCU GELİŞEN BROWN TÜMÖRLERİN EŞLÎK ETTİĞİ BÎR ÜREMİK KEMİK HASTALIĞI OLGUSU

A CASE WITH UREMIC BONE DISEASE ASSOCIATED WITH BROWN TUMORS AFTER INSUFFICIENT PARATHYROIDECTOMY

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2001

Key Words:

Keywords (Original Language):

Author Name
Abstract (2. Language): 
Almost ten percent of the patients with high-turnover uremic bone disease have brown tumors. We present here a 63-year-old male patient, on regular hemodialysis for twelve years, with subcutaneous tumoral masses appeared after subtotal thyroidectomy performed to excise four parathyroid adenomas two years ago. The patient, lost for follow-up for two years, was admitted to hospital with the complaints of severe itching, fatigue and two solid masses located, on bilateral sterno-clavicular junction two years after surgical procedure. Examinations showed a permanent pacemaker, CaxP product: 82, parathormone level (PTH): 1991 pg/ml and two residual adenomas confirmed with Tc99m MIBI (methoxyisobulil isonitrile) parathroid scintigraphy. Brown tumors were diagnosed by tru-cut biopsies of the lesions and pulmonary uptake was demonstrated in lung scintigraphy. The PTH levels returned to normal, persistant itching and fatigue disappeared after excisions of residual parathyroid adenomas and sternoclavicular lesions.
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Abstract (Original Language): 
Yüksek dönüşümlü üremik kemik hastalığı (ÜKH) olan hastaların yaklaşık %10'unda brown tümör görülür. Burada, iki yıl önce paratiroid adenomu çıkartılması için subtotal tiroidektomi yapıldıktan soma subkutan tumoral kitleler ile başvurmuş, oniki yıldır düzenli hemodiyaliz tedavisi gören 63yaşında bir erkek hasta sunmaktayız. İki yıl boyunca takip edilemeyen hasta; şiddetli kaşıntı, halsizlik ve cerrahiden iki yıl sonra her ikisternoklavikuler bileşkede'/okalize olan iki-solid kitle ile hastaneye müracaat etmftir. Yapılan incelemeler ile hastada kalıcı pacemaker varlığı, Ca x P çarpımı: 82, paratharmon (PTH) düzeyi: .1991 pg/ml,. Tc99 m MIB1 (methoxy isobutyl isonitrile) paratiroid sintigrafisinde iki adet rezidüel adenom saptanmıştır. Lezyonlara yapılan tru-cut biopsiler ile brown tümör tanısı konmuş, akciğer sintigrafisinde pulmoner tutulum belirlenmiştir. Residue! paratiroid adenomlarının ve sternoklavikuler lezyonların eksizyonu sonunda PTH düzeyleri normale dönmüş, inatçı kaşıntı ve halsizlik kaybolmuştur.
FULL TEXT (PDF): 
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  • 3
182-185
  • Turkish

REFERENCES

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Resim
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