PRIMARY HYPERPARATHYROIDISM WITH ATYPICAL LOCALIZATION

In the present article we described a case with atypical adenoma locating and primary hyperparathyroidism. This patient with a multinodal goiter and prolonged rise of Ca level in blood had CT scanning with contrast enhancement; we observed a superior mediastinal mass that intensively accumulated contrast agent. It is necessary to notice that when performing USE and scintigraphy we had no data on mass formation, so it proved necessity of further CT scanning in patients with prolonged hypercalcemia. This patient had a two-stage operative intervention with removal of parathyroid gland adenoma and her thyroid gland was also resected. Finally we could observe reliable clinical outcomes. Considering that primary referral of patients with HPT might be observed not only to endocrinologists, but also experts of other fields, it is important to enhance diagnostic vigilance of physicians. For this purpose carrying out wide-scale educational programs and screening of calcium level is necessary at routine blood test, especially in risk groups