THE PARATHYROID ADENOMAS CLINICAL AND THERAPEUTIC STUDY.

The purpose of our study was the evaluation of epidemiological profile, the diagnosis, the therapeutic management and post-operative complications for patients suffering from parathyroid adenomas. This work is based on a retrspective study. Its purpose is to discuss the results found of 26 patients operated for parathyroid adenoma at the department of visceral surgery at the Ibn Rochd University hospital of Casablanca, during a period of 07 years, from January 2010 to December 2016, based on the data collected from the clinical files of the patients. The average age of our patients was 53 with a female predominance. The circumstances of discovery for disease were various: like the etiological assessment of a bone tumor and the fortuitous discovery at the time of a cervical surgery. The clinical signs of hypocalcemia were found among 61,54% of patients (asthenia, vomiting, polyuriapolydipsia syndrome, headache, and weight loss), while bone signs were found in 19,23% of patient and renal events were found in 7,69% of patient either. The value of blood-calcium among our patients was between 94 and 176mg /l with an average of 121,81 mg /l. All of our patients presented high levels of parathormone with an average to 115,06 pg/ml and extremes with 94 and 2897 pg/ml. The ultrasound revealed the parathyoid adenoma in 84,62% cases while i twas not decisive in 15,38% cases. On the other hand, the scintigraphy was decisive for all the patients having benefited from this examination. All our patients benefited from a parathyroidectomy of pathological gland. Extemporaneous examination revealed an appearance of parathyroid adenoma in 65.38% of cases, and parathyroid hyperplasia in 34.62% of cases. Nevertheless, conventional pathological examination revealed a parathyroid adenoma in all of our patients. Two of our patients developed a transitory hypocalcemia. The evolution was marked by a normalization of the bloos-calcium of all our patients.