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Id: biblio-1150525
Autor: Sánchez De Guzmán, Gabriel; Ariza, Anibal.
Título: Hiperparatiroidismo primario: conceptos para el cirujano general / Primary hyperparathyroidism: concepts for the general surgeon
Fonte: Rev. colomb. cir;36(1):110-119, 20210000. tab, fig.
Idioma: es.
Resumo: Durante las últimas décadas, la incidencia del hiperparatiroidismo primario ha venido en aumento, muy probablemente relacionado con la mayor accesibilidad a los estudios diagnósticos; sin embargo, la forma más común de presentación clínica del hiperparatiroidismo primario es asintomática, en más del 80 % de los pacientes. En la actualidad, es menos frecuente el diagnóstico por las complicaciones renales (urolitiasis) u óseas (osteítis fibrosa quística) asociadas. Un tumor benigno de la glándula paratiroides (adenoma único), es la principal causa de esta enfermedad. Por tanto, su tratamiento usualmente es quirúrgico. A pesar de ello, no es frecuente el manejo de esta patología por el cirujano general. En este artículo se revisan conceptos claves para el diagnóstico y manejo de esta enfermedad para el médico residente y especialista en Cirugía general

During the last decades, the incidence of primary hyperparathyroidism has been increasing, most probably related to the greater accessibility to diagnostic studies; however, the most common form of clinical presentation of primary hyperparathyroidism is asymptomatic in more than 80% of patients. Diagnosis is less frequent due to associated renal (urolithiasis) or bone (osteitis fibrosa cystica) complications. A benign tumor of the parathyroid gland (single adenoma) is the main cause of this disease. Therefore, its treatment is usually surgical. Despite this, the management of this pathology by the general surgeon is not frequent. This article reviews key concepts for the diagnosis and management of this disease for the resident physician and specialist in General Surgery
Descritores: Glândulas Paratireoides
-Neoplasias das Paratireoides
Paratireoidectomia
Hiperparatireoidismo Primário
Limites: Humanos
Responsável: CO113


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Texto completo SciELO Chile
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Id: biblio-1058646
Autor: Arnold, Jorge; Martínez, Waldo; Oksenberg, Sebastian; Oksenberg, Danny.
Título: Pancreatitis aguda por hipercalcemia en el embarazo: caso clínico / Acute pancreatitis due to hypercalcemia during pregnancy: report of one case
Fonte: Rev. méd. Chile;147(8):1078-1081, ago. 2019. graf.
Idioma: es.
Resumo: Acute pancreatitis during pregnancy is uncommon and usually associated with gallstones. However other etiologies must be considered. We report a 24 years old woman with a 32 weeks pregnancy consulting for abdominal pain, nausea and vomiting. She had elevated lipase and amylase levels, a corrected serum calcium of 13.1 mg/dl and a serum phosphate of 1.6 mg/dl. A magnetic resonance colangiopancreatography showed an enlarged pancreas with inflammatory changes and a normal Wirsung duct. A parathyroid nodule was found on cervical ultrasonography. The patient was treated initially with cinacalcet with partial response. A parathyroidectomy was performed at 39 weeks of pregnancy with a good maternal and fetal evolution.
Descritores: Pancreatite/etiologia
Complicações na Gravidez/etiologia
Hipercalcemia/complicações
-Pancreatite/cirurgia
Pancreatite/diagnóstico por imagem
Neoplasias das Paratireoides/diagnóstico por imagem
Complicações na Gravidez/cirurgia
Adenoma/diagnóstico por imagem
Dor Abdominal/etiologia
Paratireoidectomia/métodos
Resultado do Tratamento
Colangiopancreatografia por Ressonância Magnética/métodos
Limites: Humanos
Feminino
Gravidez
Adulto Jovem
Tipo de Publ: Relatos de Casos
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-1088026
Autor: Valenzuela P, María José; Encalada R, Camila; Gerasch A, Tania; Brenet W, Rosemarie; Acuña B, Silvia; Fernández A, Francisca.
Título: Cáncer de paratiroides e hipercalcemia de difícil manejo: un desafío diagnóstico / Parathyroid cancer and hypercalcemia difficult to manage: a diagnostic challenge
Fonte: Rev. chil. endocrinol. diabetes;12(4):205-207, 2019.
Idioma: es.
Resumo: INTRODUCCIÓN: El carcinoma de paratiroides es una enfermedad de difícil diagnóstico, siendo perentorio una detección precoz y un tratamiento oportuno para prevenir las complicaciones. CASO CLÍNICO: Se presenta paciente de 42 años que debuta con hipercalcemia de 16.1 mg/dl, PTH 1573 pg/mL y lesión sugerente de adenoma de paratiroides. Biopsia quirúrgica identifica carcinoma paratiroideo sin invasión, realizándose posteriormente lobectomía derecha con foco de 0,1 mm de carcinoma paratiroideo, con bordes libres. En comité oncológico se decide seguimiento estricto; sin embargo, a los seis meses requiere hospitalización nuevamente por hipercalcemia, a la ecografía cervical presenta dos nódulos hipoecogénicos menores a 1 cm en lecho quirúrgico. Tomografía computada sin evidencia de lesiones. Con estos antecedentes, se decide exploración cervical, encontrándose tumor de 2 cm, multilobulado, paraesofágico. Biopsia evidencia carcinoma paratiroideo con invasión en tejido graso y músculo estriado. Se descarta radioterapia paliativa y quimioterapia debido a escasa evidencia, quedando en cuidados paliativos. DISCUSIÓN: El cáncer de paratiroides es una enfermedad de difícil diagnóstico. En muchos casos se ha descrito la crisis hipercalcémica como presentación inicial. La resección en bloque de la lesión de paratiroides con hemitiroidectomía ipsilateral es el tratamiento estándar. Es un tumor radio resistente y la quimioterapia adyuvante no ha demostrado aumento en la sobrevida. En pacientes con enfermedad inoperable, el pronóstico es pobre, siendo fundamental el control de calcemia y PTH, las cuales son la causa principal de morbimortalidad. CONCLUSIONES: El carcinoma paratiroideo es una enfermedad rara, cuyo diagnóstico y tratamiento representan un verdadero desafío clínico, siendo crucial el alto índice de sospecha. Su curso es crónico y de mal pronóstico, por lo que para pacientes de alto riesgo debe considerarse una cirugía radical desde el inicio.

INTRODUCTION: Parathyroid carcinoma is a difficult diagnosis, with early detection and timely treatment to prevent complications being imperative. CLINICAL CASE: A 42-year-old patient presenting with hypercalcemia of 16.1 mg / dl, PTH 1573 pg / mL and suggestive lesion of parathyroid adenoma is presented. Surgical biopsy identifies parathyroid carcinoma without invasion, subsequently performing right lobectomy with 0.1 mm focus of parathyroid carcinoma, with free borders. Oncological committee, strict follow-up is decided; However, at six months he requires hospitalization again for hypercalcemia, at cervical ultrasound he presents two hypoechogenic nodules smaller than 1 cm in the surgical bed. CT scan without evidence of injuries. With this background, cervical exploration is decided, finding a 2 cm, multilobed, paraesophageal tumor. Biopsy shows parathyroid carcinoma with invasion of fatty tissue and striated muscle. Palliative radiotherapy and chemotherapy are ruled out due to limited evidence, remaining in palliative care. DISCUSSION: Parathyroid cancer is a difficult diagnosis disease. In many cases the hypercalcemic crisis has been described as an initial presentation. Block resection of the parathyroid lesion with ipsilateral hemitiroidectomy is the standard treatment. It is a radioresistant tumor and adjuvant chemotherapy has not shown an increase in survival. In patients with inoperable disease, the prognosis is poor, with the control of calcemia and PTH being essential, which are the main cause of morbidity and mortality. CONCLUSIONS: Parathyroid carcinoma is a rare disease, the diagnosis and treatment of which represent a real clinical challenge, the high index of suspicion being crucial. Its course is chronic and has a poor prognosis, so for high-risk patients, radical surgery should be considered from the beginning.
Descritores: Neoplasias das Paratireoides/complicações
Neoplasias das Paratireoides/diagnóstico
Adenoma/complicações
Adenoma/diagnóstico
Hipercalcemia/etiologia
-Neoplasias das Paratireoides/cirurgia
Adenoma/cirurgia
Limites: Humanos
Feminino
Pessoa de Meia-Idade
Tipo de Publ: Relatos de Casos
Responsável: CL1.1 - Biblioteca Central


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Texto completo SciELO Brasil
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Id: biblio-827783
Autor: Cakir, Bekir; Polat, Sefika Burcak; Kilic, Mehmet; Ozdemir, Didem; Aydin, Cevdet; Süngü, Nuran; Ersoy, Reyhan.
Título: Evaluation of preoperative ultrasonographic and biochemical features of patients with aggressive parathyroid disease: is there a reliable predictive marker?
Fonte: Arch. endocrinol. metab. (Online);60(6):537-544, Nov.-Dec. 2016. tab, graf.
Idioma: en.
Resumo: ABSTRACT Objective Parathyroid cancer (PC) represents < 1% of cases of PHPT. Tumors demonstrating atypical histopathologic features and don’t fulfill criteria for carcinoma are classified as atypical adenomas (APA). The purpose of this study was to determine a biochemical or ultrasonographic feature that can predict aggressive disease requiring more extensive surgery and closer follow-up. Subjects and methods Twenty eight patients operated for PHPT and diagnosed with atypical adenoma (23 patients) or carcinoma (5 patients) were enrolled in this study. The control group consisted of 102 patients operated between the same dates and diagnosed with classical PA. Classical adenomas, atypical adenomas, and carcinomas were compared according to their biochemical and ultrasonographic parameters. Results Serum Ca levels were significantly higher in the PC group compared with the APA and classical PA groups. Serum median PTH, Serum ALP and UCa was significantly higher in the APA and carcinoma groups compared to the classical PA group. ROC analysis was made to determine the best cut off values for predicting aggressive disease were 12.45 mg/dL, 265.05 pg/mL, 154.5 IU/l, 348.5 mg/day and 21.5 mm for Ca, PTH, ALP, UCa and the adenoma diameter, respectively. Multivariate analysis showed that serum Ca, ALP and isoechoic/cystic appearance were independent predictors for aggressive disease. Conclusion Preoperatively high PTH, ALP, and UCa levels and large lesions with isoechoic or cystic appearances may be predictive of atypical adenoma or carcinoma in patients being evaluated for PHPT. In such cases, surgeons may prefer en bloc parathyroidectomy to minimally invasive surgery.
Descritores: Neoplasias das Paratireoides/sangue
Neoplasias das Paratireoides/diagnóstico por imagem
Biomarcadores Tumorais/sangue
Adenoma/cirurgia
Adenoma/patologia
Adenoma/sangue
Adenoma/diagnóstico por imagem
-Hormônio Paratireóideo/sangue
Neoplasias das Paratireoides/cirurgia
Neoplasias das Paratireoides/patologia
Cuidados Pré-Operatórios
Estudos de Casos e Controles
Cálcio/urina
Cálcio/sangue
Valor Preditivo dos Testes
Ultrassonografia/métodos
Fosfatase Alcalina/sangue
Limites: Humanos
Masculino
Feminino
Adulto
Pessoa de Meia-Idade
Idoso
Responsável: BR1.1 - BIREME


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Id: biblio-1119104
Autor: Bosco, María Belén; Diehl, María; Galich, Ana María; Jäger, Víctor; Massaro, Eduardo; Plantalech, Luisa.
Título: Hipercalcemia hipocalciurica familiar en una paciente con mutación del receptor de calcio: forma atípica de presentación y tratamiento con cinacalcet / Familial hypocalciuric hypercalcemia in a patient with calcium-sensing receptor mutation: atypical clinical presentation and treatment with cinacalcet
Fonte: Actual. osteol;13(1):69-79, Ene - Abr. 2017. graf, tab.
Idioma: es.
Resumo: El hiperparatiroidismo familiar y la hipercalcemia hipocalciúrica familiar (HHF) constituyen un subgrupo heterogéneo de trastornos con herencia mendeliana, que representan en conjunto el 5% de las causas de hipercalcemia PTH dependiente. La HHF se asocia con mutaciones del gen del receptor sensor de calcio (CaSR). Esta entidad se manifiesta, en la mayoría de los casos, con la presentación asintomática y familiar de hipercalcemia e hipocalciuria y valores elevados o normales de hormona paratiroidea (PTH). Los avances en la biología molecular han contribuido al diagnóstico, evaluación del fenotipo de cada entidad y elección del tratamiento. Se describe el caso de una paciente con hipercalcemia estudiada a partir de una tumoración de cuello asociada con una glándula paratiroides quística. Luego de un exhaustivo proceso diagnóstico se halló en el estudio genético una mutación inactivante en el gen CaSR. Teniendo en cuenta la presencia de la relación clearance calcio/clearance creatinina <0,01 y la falta de respuesta al tratamiento quirúrgico, se consideró la entidad de HHF con forma de presentación atípica. La paciente, sin tratamiento, presentaba un progresivo incremento de la calcemia luego de la cirugía de las glándulas paratiroides, que no se controló con el uso de bifosfonatos y evolucionó con episodios de mareos y desmayos frecuentes sin causa neurológica o cardiovascular detectada. Por lo tanto, se inició el tratamiento con cinacalcet, con el cual se obtuvo una buena respuesta terapéutica: descenso de la calcemia y mejoría de la sintomatología luego de un año de su comienzo. El cinacalcet es una herramienta terapéutica de importancia en estos raros casos de HHF. (AU)

Familial hyperparathyroidism including familial hypocalciuric hypercalcemia (FHH) is an heterogeneous subgroup of disorders with Mendelian inheritance, that account for 5% of PTH dependent hypercalcemia. FHH is associated with mutations of the calcium receptor (CaSR) gene. This entity is manifested by hypercalcemia with hypocalciuria and high or normal levels of parathyroid hormone (PTH) generally asymptomatic and with familial presentation. Advances in molecular biology have contributed to the diagnosis, evaluation of the phenotype of each entity and the choice of treatment. We describe a patient with hypercalcemia diagnosed following the finding of a neck tumor associated with cystic parathyroids. After an exhaustive diagnostic process, an inactivating mutation in the CaSR gene was found. Considering the presence of a ratio clearance calcium / clearance creatinine <0.01 and the lack of response to surgical treatment, HHF entity with atypical presentation was considered. The patient exhibited progressive increase in serum calcium following parathyroid surgery, which was not controlled with the use of bisphosphonates and evolved into episodes of frequent dizziness and fainting, without neurological or cardiovascular causes. Treatment with cinacalcet was initiated, with a good therapeutic response. The use of cinacalcet is a useful therapeutic tool in these rare cases of FHH. (AU)
Descritores: Receptores de Detecção de Cálcio/genética
Cinacalcete/farmacologia
Hipercalcemia/genética
-Hormônio Paratireóideo/sangue
Neoplasias das Paratireoides/cirurgia
Neoplasias das Paratireoides/diagnóstico por imagem
Glândulas Paratireoides/cirurgia
Vitamina D/sangue
Cálcio/urina
Cálcio/sangue
Reação em Cadeia da Polimerase
Hipofosfatemia/sangue
Creatinina/sangue
Receptores de Detecção de Cálcio/fisiologia
Diagnóstico Diferencial
Difosfonatos/uso terapêutico
Cinacalcete/administração & dosagem
Hipercalcemia/diagnóstico
Hipercalcemia/etiologia
Hipercalcemia/metabolismo
Hipercalcemia/tratamento farmacológico
Limites: Humanos
Feminino
Adolescente
Tipo de Publ: Relatos de Casos
Responsável: AR2.1 - Biblioteca Central


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Id: biblio-1117571
Autor: Ramírez Stieben, Luis Agustín; Guadagnoli, Nahuel Luis; Sylvestre Begnis, Gustavo Adolfo; Farías, Mariano; Luján, Silvia.
Título: Crisis hipercalcémica causada por adenoma paratiroideo: reporte de un caso clínico / Hypercalcemic crisis due to parathyroid adenoma: report of a clinical case
Fonte: Actual. osteol;13(3):243-250, Sept - DIc. 2017. ilus, tab.
Idioma: es.
Resumo: La hipercalcemia es un trastorno común que representa aproximadamente el 0,6% de todas las admisiones médicas agudas. El hiperparatiroidismo primario (HPTP) y las neoplasias malignas son las dos causas más comunes de elevación de los niveles séricos de calcio; constituyen, en conjunto, alrededor del 90% de todos los casos. La presentación sintomática clásica de la hipercalcemia se observa con relativa poca frecuencia en el mundo desarrollado; la presentación más común es la detección asintomática en las pruebas bioquímicas. Sin embargo, en casos raros, el HPTP puede desarrollar hipercalcemia aguda, grave y sintomática, llamada crisis hipercalcémica (CH). Esta condición se asocia a alteraciones profundas en el estado mental y las funciones cardíaca, renal y gastrointestinal en presencia de concentraciones marcadamente elevadas de calcio sérico y paratohormona (PTH). Mientras que algunas elevaciones en el calcio sérico pueden ser bien toleradas, los síntomas de la CH son severos. Si el tratamiento se retrasa, la CH puede provocar la muerte. Describimos el caso de un paciente masculino que ingresa en la unidad de cuidados críticos por una CH secundaria a un HPTP por adenoma paratiroideo. (AU)

Hypercalcaemia is a most common disorder, accounting for approximately 0,6% of all acute medical admissions. Primary hyperparathyroidism (PHPT) and malignancy are the two most common causes of increased serum calcium levels, together accounting for about 90% of all cases. The classical symptomatic presentation of hypercalcaemia is seen relatively rarely in the developed world, the most common presentation being asymptomatic and detected following on biochemical testing. However, in rare cases HPTP can result in acute, severe and symptomatic hypercalcemia, called hypercalcemic crisis (HC). This condition is associated with profound disturbances in mental status, and cardiac, renal, and gastrointestinal function in the presence of markedly increased serum calcium and parathyroid hormone (PTH) concentrations. While some elevations in serum calcium can be well tolerated, symptoms of HC are severe. If treatment is delayed, HC can result in death. We describe herein a case of a male patient who was admitted to the intensive care unit as a consequence of HC resulting from elevated PTH, secondary to a parathyroid adenoma. We describe the case of a male patient who was admitted to the critical care unit for a HC mediated by PTH secondary to a parathyroid adenoma. (AU)
Descritores: Neoplasias das Paratireoides/complicações
Glândulas Paratireoides/patologia
Hiperparatireoidismo Primário/complicações
Hipercalcemia/induzido quimicamente
-Hormônio Paratireóideo/metabolismo
Hormônio Paratireóideo/sangue
Neoplasias das Paratireoides/cirurgia
Neoplasias das Paratireoides/diagnóstico por imagem
Glândulas Paratireoides/cirurgia
Deficiência de Vitamina D/sangue
Calcitriol/administração & dosagem
Gluconato de Cálcio/administração & dosagem
Perda de Peso
Anti-Inflamatórios não Esteroides/uso terapêutico
Cálcio/administração & dosagem
Cálcio/sangue
Diálise Renal
Colecalciferol/administração & dosagem
Desidratação
Diuréticos/administração & dosagem
Hiperparatireoidismo Primário/cirurgia
Hiperparatireoidismo Primário/diagnóstico
Cinacalcete/administração & dosagem
Pamidronato/administração & dosagem
Soluções Cristaloides/administração & dosagem
Hipercalcemia/diagnóstico
Hipercalcemia/tratamento farmacológico
Hipercalcemia/sangue
Limites: Humanos
Masculino
Pessoa de Meia-Idade
Tipo de Publ: Relatos de Casos
Responsável: AR2.1 - Biblioteca Central


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Id: lil-646615
Autor: Carranza, Julio; Miyahira, Juan.
Título: Adenoma de paratiroides en gammagrafía / Parathyroid adenoma on scintigraphy
Fonte: Rev. méd. hered;23(2):143-143, abr.-jun. 2012. ilus.
Idioma: es.
Descritores: Adenoma
Cintilografia
Neoplasias das Paratireoides
Limites: Humanos
Feminino
Idoso
Tipo de Publ: Relatos de Casos
Responsável: PE1.1 - Oficina Universitária de Biblioteca


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Id: lil-786549
Autor: Casas-Castañeda, Jorge; Muñoz-Aguirre, Patricia.
Título: Cáncer de paratiroides con tumores marrones / Parathyroid cancer tumors with brown
Fonte: Rev. Soc. Peru. Med. Interna;28(2):87-93, abr.-jun.2015. ilus, tab.
Idioma: es.
Resumo: Paciente con cáncer de paratiroides, hipercalcemia grave y un importante compromiso óseo de larga evolución, con el desarrollo de tumores marrones. Sorprendentemente tuvo una gammagrafía paratiroidea con sestamibi que no mostró la neoplasia paratiroidea, lo que demoró la solución de la condición de esta paciente. Fue sometida a paratiroidectomía más tiroidectomía total y desarrolló hipocalcemia en el postoperatorio...

Patient with parathyroid cancer and severe hypercalcemia and a major bone compromise long-evolution with the development of brown tumors, surprisingly a parathyroid scintigraphy with sestamibi 13 fail to show the parathyroid neoplasia and this delayed the solution of this patient's condition. It was subjected to parathyroidectomy and total thyroidectomy, with development of hypocalcemia in the postoperative period...
Descritores: Hipercalcemia
Neoplasias Bucais
Neoplasias das Paratireoides
Neoplasias Ósseas
Limites: Humanos
Feminino
Pessoa de Meia-Idade
Tipo de Publ: Relatos de Casos
Responsável: PE1.1 - Oficina Universitária de Biblioteca


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Id: lil-540569
Autor: Juárez García, Marcela; Navarro Falcón, Magnolia.
Título: Neoplasia endocrina múltiple tipo 1 / Multiple endocrine neoplasia type 1
Fonte: Rev. Soc. Peru. Med. Interna;22(2):79-81, abr.-jun. 2009. ilus.
Idioma: es.
Resumo: Se reporta un caso infrecuente de neoplasia endocrina múltiple tipo 1, en una mujer de 44 años de edad. El diagnóstico se basó en el hallazgo de úlceras gástricas múltiples asociadas a hipergrastinemia, hipercalcemia relacionada con un adenoma paratiroideo e hiperprolactinemia debida a un microadenoma hipofisiario.

We report an infrequent case of multiple endocrine neoplasia type 1 in a 44 year-old woman. The diagnosis was based after the finding of multiple duodenal ulcers associated to hypergastrinemia, hypercalcemia related to a parathyroid adenoma and hyperprolactinemia due to a hypophyseal microadenoma.
Descritores: Gastrinas
Gastrinoma
Hipercalcemia
Neoplasia Endócrina Múltipla
Neoplasias Hipofisárias
Neoplasias das Paratireoides
Limites: Humanos
Feminino
Adulto
Tipo de Publ: Relatos de Casos
Responsável: PE1.1 - Oficina Universitária de Biblioteca


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Id: lil-722011
Autor: Corpas, Ma Fernanda; Fiol, Verónica; Cóppola, Francisco.
Título: Hiperparatiroidismo y embarazo. Reporte de un caso clínico / Hyperparathyroidism and pregnancy. Clinical case report
Fonte: Horiz. méd. (Impresa);13(3):52-57, jul.-sept. 2013. tab, ilus.
Idioma: es.
Resumo: Primary hyperparathyroidism is characterized by an increase in the secretion of parathyroid hormone (PTH), which causeshypercalcemia, determining, in varying degrees, the involvement of various organs and systems, increasing both maternaland fetal morbidity and mortality and compromising the prognosis of the binomial.We present the clinical case of a 28-year-old patient, primigravida, with a personal history of bilateral renal lithiasis,repeated pyelonephritis and a presumably nonfunctioning thyroid nodule. At 17 weeks ́ gestational age she is admitted forPRGHUDWH DQHPLD D PRQWK RI HYROXWLRQ SRRUO/ WROHUDWHG 3K/VLFDO H[DPLQDWLRQ ÀQGV QRGXOH LQ WKH WK/URLG ORGJH RI UDSLG JURZWK /DERUDWRU/ SURÀOH UDLVHV K/SHUFDOFHPLD DQG LQFUHDVHG LQWDFW 37+ PDNLQJ GLDJQRVLV RI SULPDU/ K/SHUSDUDWK/URLGLVP Surgical resection is performed at 24 weeks ́. The pathologic diagnosis was cystic parathyroid adenoma. In the evolutionshe presented hypothyroidism with normal levels of serum calcium and PTH. Being treated with calcium, calcitriol and T4.At 39 weeks labor begins spontaneously and a cesarean section is performed with diagnosis of non-reassuring fetal status,obtaining a vigorous newborn, with appropriate weight for gestational age. Good postpartum evolution
Descritores: Adenoma
Gravidez
Hiperparatireoidismo Primário
Hormônio Paratireóideo
Neoplasias das Paratireoides
Limites: Feminino
Tipo de Publ: Relatos de Casos
Responsável: PE1.1 - Oficina Universitária de Biblioteca



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