problendoПроблемы ЭндокринологииProblems of Endocrinology0375-96602308-1430Endocrinology Research Centre10.14341/probl13425problendo-13425Research ArticleКлиническая эндокринологияClinical endocrinologyТактика ведения первичного гиперпаратиреоза c редкой локализацией эктопированного образования околощитовидной железыManagement of primary hyperparathyroidism with rare localization of ectopic adenoma parathyroid glandhttps://orcid.org/0000-0002-0306-6588АбойшеваЕ. А.AboishevaE. A.

Абойшева Елизавета Андреевна

Москва

Elizaveta A. Aboisheva, MD

Moscow

aboysheva.elizaveta@endocrincentr.ruhttps://orcid.org/0000-0002-4563-650XАвсиевичЕ. С.AvsievichE. S.

Авсиевич Екатерина Сергеевна

Москва

Ekaterina S. Avsievich

Moscow

ekaterina-avsievich@yandex.ruhttps://orcid.org/0000-0002-6954-1126КорчагинаМ. О.KorchaginaM. O.

Корчагина Мария Олеговна 

117036, Москва, ул. Дм. Ульянова, д. 11 

Maria O. Korchagina

11 Dm. Ulyanova street, 117036 Moscow

kmylavender@gmail.comhttps://orcid.org/0000-0001-5652-2607ДегтяревМ. В.DegtyarevM. V.

Дегтярев Михаил Владимирович

Москва

Mikhail V. Degtyarev, MD

Moscow

germed@mail.ruhttps://orcid.org/0000-0001-5952-5846БибикЕ. Е.BibikE. E.

Бибик Екатерина Евгеньевна

Москва

Ekaterina E. Bibik, MD

Moscow

bibikaterina@mail.ruhttps://orcid.org/0000-0001-7098-4584БельцевичД. Г.BeltsevichD. G.

Бельцевич Дмитрий Германович, д.м.н., профессор

Москва

Dmitriy G. Beltsevich, MD, PhD, Professor

Moscow

belts67@gmail.comhttps://orcid.org/0000-0001-6539-466XПигароваЕ. А.PigarovaE. A.

Пигарова Екатерина Александровна, д.м.н.

Москва

Ekaterina A. Pigarova

Moscow

kpigarova@gmail.comhttps://orcid.org/0000-0003-3785-0335ШереметаМ. С.SheremetaM. S.

Шеремета Марина Сергеевна, к.м.н.

Москва

Marina S. Sheremeta, PhD

Moscow

marina888@yandex.ruНациональный медицинский исследовательский центр эндокринологииРоссияEndocrine Research CentreRussian Federation2025010420247112026Copyright © Абойшева Е.А., Авсиевич Е.С., Корчагина М.О., Дегтярев М.В., Бибик Е.Е., Бельцевич Д.Г., Пигарова Е.А., Шеремета М.С., 20252025Абойшева Е.А., Авсиевич Е.С., Корчагина М.О., Дегтярев М.В., Бибик Е.Е., Бельцевич Д.Г., Пигарова Е.А., Шеремета М.С.Aboisheva E.A., Avsievich E.S., Korchagina M.O., Degtyarev M.V., Bibik E.E., Beltsevich D.G., Pigarova E.A., Sheremeta M.S.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/13425

Эктопическое расположение образований околощитовидных желез (ОЩЖ) у пациентов с первичным гиперпаратиреозом (ПГПТ) может затруднять проведение топической диагностики заболевания. Мы представляем клинический случай ПГПТ у пациентки 84 лет, обусловленный эктопированной аденомой ОЩЖ, локализованной позади правой внутренней яремной вены в проекции правой поднижнечелюстной слюнной железы. Отсутствие визуализации опухоли в течение длительного времени и высокий риск осложнений хирургического вмешательства требовали подбора консервативного лечения для контроля гиперкальциемии и коррекции осложнений ПГПТ. Ввиду тяжелого остеопороза и сопутствующей недостаточности витамина D к терапии деносумабом добавлен колекальциферол в насыщающих дозах под динамическим контролем показателей фосфорно-кальциевого обмена, что позволило достичь значимого снижения уровня ПТГ при сохранении нормокальциемии.

Topical diagnosis can be severely complicated in patients with primary hyperparathyroidism (PHPT) due to the ectopic placement of parathyroid gland (PTG) formations. We report a clinical case of PHPT in an 84-year-old patient caused by ectopic PTG adenoma located behind the right internal jugular vein at the level of the right submandibular gland. The impossibility of surgery for a long time due to the absence of a topical diagnosis has necessitated conservative treatment was required to get the hypercalcemia under control. In view of the concomitant deficiency of vitamin D, an attempt was made to use therapy with saturating doses of cholecalciferol under dynamic monitoring of the indicators of phosphorus-calcium metabolism, which allowed to achieve a significant decrease in PTH levels while maintaining normocalcemia.

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