Abstract
Pharyngoeosophageal diverticula are the most common type of diverticula of the eosophagus and are often encountered in the elderly. Parathyroid adenomas are the most common cause of primary hyperparathyroidism. In this case report, we present the case of a 73 year old female patient who was admitted to the endocrinology outpatient clinic in our hospital, complaining of profuse weight gain. The patient was later operated on due to the discovery of a multinodular goitre. Incidentally, the patient appeared to have a synchronous parathyroid adenoma and Zenker diverticulum, both of which were diagnosed intraoperatively. A total thyroidectomy along with excision of the adenoma and stapler-assisted diverticulectomy was performed. The patient did well during her postoperative course. To our knowledge, this is the first report in the literature of a patient that was operated on due to a multinodular goitre with synchronous parathyroid adenoma and Zenker diverticulum.
Keywords:
Zenker diverticulum, pharyngoesophageal diversifolium, parathyroid adenoma, thyroid surgery
References
1van Overbeek JJ. Pathogenesis and methods of treatmentof Zenker's diverticulum. Ann Otol Rhinol Laryngol 2003; 112: 583-593.
2Cook IJ, Gabb M, Panagopoulos V, et al. Pharyngeal (Zenker's) diverticulum is a disorder of upper esophageal sphincter opening. Gastroenterology 1992; 103: 1229-1235.
3Reid BJ, Weinstein WM, Lewin KJ, et al. Endoscopic biopsy can detect highgrade dysplasia or early adenocarcinoma in Barrett's esophagus without grossly recognizable neoplastic lesions. Gastroenterology 1988; 94: 81-90.
4Salti GI, Fedorak I, Yashiro T, et al. Continuing evolution in the operative management of primary hyperparathyroidism. Arch Surg 1992; 127: 831- 837. http://dx.doi.org/10.1001/archsurg. 1992.01420070095018 [CrossRef]
5Kaplan EL, Salti GI, Hara H, et al. Results and complications of the surgical treatment of primary hyperparathyroidism. Ann Ital Chir 1993; 64: 365-370.
6Ludlow A. A case of obstructed deglutition from a preternatural dilatation of and bag formed in the pharynx. In: Medical Observations and Enquiries by a Society of Physicians in London 1769; 3: 85-101.
7Zenker FA, von Ziemssen H. Krankenheiten des oesophagus. In : von Ziemssen H, ed. Heandbuch der Speciellen Pathologie and Therapie. Vogel, Leipzig 1877; 7: 1-87.
8Yılmaz M, Ersin S, Kapkaç M, ve ark. Zenker divertikülü ve cerrahi tedavisi. Türkiye Klinikleri J Gastroenterohepatol 1996; 7: 160-162.
9Ferreira LE, Simmons DT, Baron TH. Zenker's diverticula: pathophysiology, clinical presentation, and flexible endoscopic management. Dis Esophagus 2008; 21: 1-8.
10Marchesi M, Biffoni M, Benedetti RN, et al. Incidental parathyroid adenoma as with normocalcemia discovered during thyroid operations. Surg Today 2001; 31: 996-998. http://dx.doi.org/10.1007/ s005950170009 [CrossRef]
11Walts AE, Braunstein G. Fine-needle aspiration of a paraesophageal diverticulum masquerading as a thyroid nodule. Diagn Cytopathol 2006; 34: 843-845. http://dx.doi.org/10.1002/dc.20570 [CrossRef]
12Kim J, Kim YJ, Kim EK, et al. Incidentally found pharyngoesophageal diverticulum on ultrasonography. Yonsei Med J 2002; 43: 271-273.
13de los Santos ET, Keyhani-Rofagha S, Cunningham JJ, et al. Cystic thyroid nodules. The dilemma of malignant lesions. Arch Intern Med 1990; 150: 1422- 1427. http://dx.doi.org/10.1001/archinte.
