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岭南现代临床外科 ›› 2012, Vol. 12 ›› Issue (04): 354-355.

• 临床研究 • 上一篇    下一篇

甲状旁腺肿瘤合并甲状旁腺功能亢进症诊治经验

林志强1,王在国2,叶振伟2,胡夏荣2,俞武生2,黄志天2,何润沛2,郑惊雷2,赖国威2,邓润枢2,梁子君2   

  1. 1. 东莞市人民医院
    2. 东莞市人民医院肿瘤防治中心
  • 通讯作者: 林志强

  • Received:2012-04-10 Revised:2012-05-18 Online:2012-08-20 Published:2012-08-20

摘要: 目的 总结甲状旁腺肿瘤合并甲状旁腺功能亢进症的诊治体会。方法 回顾性分析我院2007年2月至2012年2月收治的4例甲状旁腺肿瘤合并甲状旁腺功能亢进症的临床特征、诊断过程、治疗情况与治疗效果。结果 以多发性骨折及颈前肿块为首发症状者各2例,入院时3例被误诊(误诊率75%,3/4),3例并存泌尿系结石及甲状腺疾病;受检者全部存在高血钙、低血磷、高尿钙及甲状旁腺激素升高;术前B超、CT检查与术中及术后病理诊断符合率分别为75%及100%;术中见2例位于甲状腺右叶下极后下方,1例位于甲状腺左叶下极后下方,另1例位于左叶甲状腺腺体内;3例良性者(甲状旁腺腺瘤)行局部切除,1例恶性者(甲状旁腺癌)行左甲状腺全切除;术后早期均出现一过性低钙低钾低镁血症,2周内电解质、尿钙、甲状旁腺激素水平均恢复正常。结论 此病极易误诊,术前必须注重定性及定位诊断,外科手术切除是首选的治疗方法。

关键词: 甲状旁腺肿瘤, 甲状旁腺功能亢进症, 诊断, 外科治疗

Abstract: [Abstract] Objective To summarize the diagnosis and treatment of the parathyroid tumors associated with hyperparathyroidism. Methods From February 2007 to February 2012, the clinical data of 4 cases with parathyroid tumors associated with hyperparathyroidism were analyzed retrospectively. Results Among them,the multiple fractures and anterior neck mass as primary symptom were in 2 and 2 cases respectively. In the admission, 3 cases were misdiagnosed and misdiagnosed rate was 75%(3/4). Three cases were coexisted urinary calculi and thyroid disease. All cases had hypercalcemia, hypophosphatemia,hypercalcuciuria and high parathyroid hormone. Peroperative coincident rates of ultrasound, CT scan and intraoperative and postoperative pathological diagnosis were in 75%(3/4) and 100%(4/4) respectively. Three cases with parathyroid sdenoma underwent local resection of lesion. One case with parathyroid carcinoma underwent left hemithyroidectomy and parathroidectomy. Four cases occurred hypocalcemia, hypokalemia and hypomagnesemia early postoperatively. The serum electrolytes and PTH level returned to normal limit within two weeks. Conclusion Parathyroid tumors are misdiagnosed easily. Qualitative and localized diagnosis are very importment before operation. Surgical resection is a first choice for the treatment of parathyroid tumors.

Key words: Parathyroid tumor, Hyperparathyroidism, Diagnosis, Surgical treatment