problendoПроблемы ЭндокринологииProblems of Endocrinology0375-96602308-1430Endocrinology Research Centre10.14341/probl12713problendo-12713Research ArticleКлиническая эндокринологияClinical endocrinologyСлучай поздней диагностики гигантской аденомы околощитовидной железы в сочетании с фиброзно-кистозным остеитом и бурой опухолью верхней челюсти: клиническое наблюдениеThe case of late diagnosis of giant parathyroid adenoma in combination with fibrocystic osteitis and brown tumor of the upper jaw: a case reporthttps://orcid.org/0000-0002-2081-8665ИльичеваЕ. А.BersenevG. A.

Ильичева Елена Алексеевна, д.м.н., профессор

SPIN-код: 3624-4643

Иркутск

Gleb A. Bersenev

1 ulica Borcov Revolyucii, 664003 Irkutsk

SPIN-код: 1467-8503

lena_isi@mail.ruhttps://orcid.org/0000-0002-6887-8325БерсеневГ. А.IlyichevaE. A.

Берсенев Глеб Александрович, аспирант, врач-хирург

664003, Иркутск, ул. Борцов Революции, д. 1

SPIN-код: 1467-8503

Elena A. Ilyicheva, MD, PhD, Professor

SPIN-код: 3624-4643

Irkutsk

glbersenev17@gmail.comhttps://orcid.org/0000-0002-5082-7028ГригорьевЕ. Г.GriroryevE. G.

Григорьев Евгений Георгиевич, д.м.н., профессор, член-корреспондент РАН

SPIN-код: 8969-4112

Иркутск

Eugene G. Grigoryev, MD, PhD, Professor

SPIN-код: 8969-4112

Irkutsk

egg@iokb.ruИркутский научный центр хирургии и травматологииРоссияIrkutsk Scientific Centre of Surgery and TraumatologyRussian FederationИркутский научный центр хирургии и травматологии; Иркутский государственный медицинский университетРоссияIrkutsk Scientific Centre of Surgery and Traumatology; Irkutsk State Medical UniversityRussian Federation2021140320216724956Copyright © Ильичева Е.А., Берсенев Г.А., Григорьев Е.Г., 20212021Ильичева Е.А., Берсенев Г.А., Григорьев Е.Г.Bersenev G.A., Ilyicheva E.A., Griroryev E.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.probl-endojournals.ru/jour/article/view/12713

Обсуждается поздняя диагностика гигантской аденомы околощитовидной железы (ОЩЖ) с первичным гиперпаратиреозом (ПГПТ) и развитием фиброзно-кистозного остеита с «бурой» опухолью верхней челюсти. В течение 8 лет пациентка наблюдалась у эндокринолога по месту жительства по поводу сахарного диабета 2 типа и многоузлового зоба.Последние 5 лет присутствовала клиническая картина ПГПТ, однако диагноз был установлен онкологом после выявления «бурой» опухоли верхней челюсти. По данным мультиспиральной компьютерной томографии и сцинтиграфии с 99mTc-МИБИ обнаружены очаговое образование в верхней челюсти справа, литические очаги в костях свода черепа, таза, нижних конечностей, ребрах справа, а также гигантская аденома ОЩЖ справа. Учитывая повышенный риск наличия у пациентки злокачественного новообразования ОЩЖ, проведено расширенное хирургическое лечение ПГПТ в объеме enblock с достижением ремиссии ПГПТ. Данное клиническое наблюдение иллюстрирует вариант тяжелого течения ПГПТ с развитием такого редкого осложнения, как фиброзно-кистозный остеит, и демонстрирует важность своевременной диагностики.

In this case report the authors inform about late diagnosis of giant adenoma of the parathyroid gland with primary hyperparathyroidism (PHPT) and the development of fibrocystic osteitis with a «brown» tumor of the upper jaw. The patient has been under the care endocrinologist with type 2 diabetes mellitus and multinodular goiter for 8 years.The last 5 years there was a clinical manifestation of PHPT, but the diagnosis was made by an oncologist after the detection of a «brown» tumor of the upper jaw. According to multispiral computed tomography and scintigraphy with 99mTc-MIBI, a focal lesion was found in the upper jaw on the right, lytic foci in the bones of the cranial vault, pelvis, lower extremities, ribs on the right, as well as a giant parathyroid adenoma on the right. According to the increased risk of the patient having a malignant neoplasm of the parathyroid gland, an extended surgical treatment of PHPT in the enblock volume was carried out with the achievement of remission of the PHPT. This clinical case illustrates a variant of the severe course of PHPT with the development of such a rare complication as fibrocystic osteitis and demonstrates the importance of timely diagnosis.

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The authors declare that there are no conflicts of interest present.