甲状腺癌术后再发甲状旁腺癌1例诊治分析并文献复习_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 张广 , 宋灵敏 , 周乐 , 刘晓莉 , 于天宇 , 雒毅强 ,  孙辉

吉林大学中日联谊医院甲状腺外科吉林省外科转化医学中心实验室（吉林长春 130033）;

Corresponding author：

孙辉, Email: sunhui1229@163.com

Keywords：

甲状旁腺癌; 甲状腺癌; 诊疗; 高钙血症

DOI：

10.7507/1007-9424.20150293

Video：

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目的探讨甲状旁腺癌的临床诊疗经验。方法回顾性分析笔者所在医院收治的1例甲状腺癌术后再发甲状旁腺癌病例的临床资料和诊疗经过，并进行文献复习。结果患者第1次因甲状腺癌行手术治疗，术前甲状旁腺素（PTH）及血钙水平轻度升高，但未见甲状旁腺肿瘤，术后PTH及血钙降至正常水平。患者第2次以颈部肿物、甲状旁腺功能亢进症、高钙血症入院行手术治疗后，PTH及血钙再次降至正常水平，石蜡切片病理标本经专家会诊明确甲状旁腺癌的诊断。第2次术后1年患者的甲状旁腺癌复发，行微创消融治疗，术后PTH及血钙有所下降，但未达理想范围，现仍在随访中。结论甲状腺癌并发甲状旁腺癌临床罕见，其术前诊断困难，根据术后石蜡病理检查及免疫组化检查可以确诊。手术是其最有效的治疗方法，术后局部复发率较高，故术后应长期监测血钙和血PTH水平，尽早发现肿瘤复发或转移情况，尽早治疗，以求提高生存率和延长无瘤生存期。

Citation： 张广, 宋灵敏, 周乐, 刘晓莉, 于天宇, 雒毅强, 孙辉. 甲状腺癌术后再发甲状旁腺癌1例诊治分析并文献复习. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(9): 1127-1129. doi: 10.7507/1007-9424.20150293 Copy

1.	Lee PK, Jarosek SL, Virnig BA, et al. Trends in the incidence and treatment of parathyroid cancer in the United States. Cancer, 2007, 109(9):1736-1741.
2.	Basceken SI, Genc V, Ersoz S, et al. Is local resection sufficient for parathyroid carcinoma?. Clinics (Sao Paulo), 2015, 70(4):247-249.
3.	Schaapveld M, Jorna FH, Aben KK, et al. Incidence and prognosis of parathyroid gland carcinoma:a population-based study in The Netherlands estimating the preoperative diagnosis. Am J Surg, 2011, 202(5):590-597.
4.	Sharretts JM, Kebebew E, Simonds WF. Parathyroid cancer. Semin Oncol, 2010, 37(6):580-590.
5.	Witteveen JE, Haak HR, Kievit J, et al. Challenges and pitfalls in the management of parathyroid carcinoma:17-year follow-up of a case and review of the literature. Horm Cancer, 2010, 1(4):205-214.
6.	Korpi-Hyövälti E, Cranston T, Ryhänen E, et al. CDC73 intragenic deletion in familial primary hyperparathyroidism associated with parathyroid carcinoma. J Clin Endocrinol Metab, 2014, 99(9):3044-3048.
7.	Sulaiman L, Haglund F, Hashemi J, et al. Genome-wide and locus specific alterations in CDC73/HRPT2-mutated parathyroid tumors. PLoS One, 2012, 7(9):e46325.
8.	Wang O, Wang C, Nie M, et al. Novel HRPT2/CDC73 gene muta-tions and loss of expression of parafibromin in Chinese patients with clinically sporadic parathyroid carcinomas. PLoS One, 2012, 7(9):e45567.
9.	Milas M, Mensah A, Alghoul M, et al. The impact of office neck ultrasonography on reducing unnecessary thyroid surgery in patients undergoing parathyroidectomy. Thyroid, 2005, 15(9):1055-1059.
10.	徐少明, 郑毅雄, 王平, 等. 原发性甲状旁腺功能亢进症并发甲状腺疾病21例临床分析. 中华普通外科杂志, 2007, 22(2):81-84.
11.	Sidhu S, Campbell P. Thyroid pathology associated with primary hyperparathyroidism. Aust N Z J Surg, 2000, 70(4):285-287.
12.	Javadi H, Jallalat S, Farrokhi S, et al. Concurrent papillary thyroid cancer and parathyroid adenoma as a rare condition:a case report. Nucl Med Rev Cent East Eur, 2012, 15(2):153-155.
13.	崔爱民, 柏楠, 张自琴, 等. 原发性甲状旁腺功能亢进合并甲状腺病变的临床病因分析. 山东医药, 2011, 51(40):91-93.
14.	Sturniolo G, Gagliano E, Tonante A, et al. Parathyroid carcinoma:case report. G Chir, 2013, 34(5-6):170-172.
15.	徐艺桐, 张观宇, 许立莉, 等. 无功能性甲状旁腺癌一例报道及文献复习. 中华临床医师杂志:电子版, 2012, 6(10):2807-2808.
16.	陈超, 陈红, 刘宝瑞, 等. 非功能性甲状旁腺癌1例. 临床肿瘤学杂志, 2011, 16(10):959-960.
17.	Gao WC, Ruan CP, Zhang JC, et al. Nonfunctional parathyroid carcinoma. J Cancer Res Clin Oncol, 2010, 136(7):969-974.
18.	Kebebew E, Arici C, Duh QY, et al. Localization and reoperation results for persistent and recurrent parathyroid carcinoma. Arch Surg, 2001, 136(8):878-885.
19.	Sriphrapradang C, Sornmayura P, Chanplakorn N, et al. Fine-needle aspiration cytology of parathyroid carcinoma mimic hürthle cell thyroid neoplasm. Case Rep Endocrinol, 2014, 2014:680876.
20.	Agarwal G, Dhingra S, Mishra SK, et al. Implantation of parathyroid carcinoma along fine needle aspiration track. Langenbecks Arch Surg, 2006, 391(6):623-626.
21.	Delellis RA. Parathyroid carcinoma:an overview. Adv Anat Pathol, 2005, 12(2):53-61.
22.	Schulte KM, Talat N. Diagnosis and management of parathyroid cancer. Nat Rev Endocrinol, 2012, 8(10):612-622.
23.	Owen RP, Silver CE, Pellitteri PK, et al. Parathyroid carcinoma:a review. Head Neck, 2011, 33(3):429-436.
24.	Campenni A, Ruggeri RM, Sindoni A, et al. Parathyroid carcinoma as a challenging diagnosis:report of three cases. Hormones (Athens), 2012, 11(3):368-376.
25.	Montenegro FL, Chammas MC, Juliano AG, et al. Ethanol injection under ultrasound guidance to palliate unresectable parathyroid carcinoma. Arq Bras Endocrinol Metabol, 2008, 52(4):707-711.
26.	Tochio M, Takaki H, Yamakado K, et al. A case report of 20 lung radiofrequency ablation sessions for 50 lung metastases from parathyroid carcinoma causing hyperparathyroidism. Cardiovasc Intervent Radiol, 2010, 33(3):657-659.
27.	Shane E. Clinical review 122:parathyroid carcinoma. J Clin Endo-crinol Metab, 2001, 86(2):485-493.
28.	胡琳, 崔爱民, 柏楠, 等. 甲状旁腺癌的诊断和治疗(附7例报道). 中国普外基础与临床杂志, 2015, 22(1):75-80.
29.	Kleinpeter KP, Lovato JF, Clark PB, et al. Is parathyroid carcinoma indeed a lethal disease?. Ann Surg Oncol, 2005, 12(3):260-266.

1. Lee PK, Jarosek SL, Virnig BA, et al. Trends in the incidence and treatment of parathyroid cancer in the United States. Cancer, 2007, 109(9):1736-1741.
2. Basceken SI, Genc V, Ersoz S, et al. Is local resection sufficient for parathyroid carcinoma?. Clinics (Sao Paulo), 2015, 70(4):247-249.
3. Schaapveld M, Jorna FH, Aben KK, et al. Incidence and prognosis of parathyroid gland carcinoma:a population-based study in The Netherlands estimating the preoperative diagnosis. Am J Surg, 2011, 202(5):590-597.
4. Sharretts JM, Kebebew E, Simonds WF. Parathyroid cancer. Semin Oncol, 2010, 37(6):580-590.
5. Witteveen JE, Haak HR, Kievit J, et al. Challenges and pitfalls in the management of parathyroid carcinoma:17-year follow-up of a case and review of the literature. Horm Cancer, 2010, 1(4):205-214.
6. Korpi-Hyövälti E, Cranston T, Ryhänen E, et al. CDC73 intragenic deletion in familial primary hyperparathyroidism associated with parathyroid carcinoma. J Clin Endocrinol Metab, 2014, 99(9):3044-3048.
7. Sulaiman L, Haglund F, Hashemi J, et al. Genome-wide and locus specific alterations in CDC73/HRPT2-mutated parathyroid tumors. PLoS One, 2012, 7(9):e46325.
8. Wang O, Wang C, Nie M, et al. Novel HRPT2/CDC73 gene muta-tions and loss of expression of parafibromin in Chinese patients with clinically sporadic parathyroid carcinomas. PLoS One, 2012, 7(9):e45567.
9. Milas M, Mensah A, Alghoul M, et al. The impact of office neck ultrasonography on reducing unnecessary thyroid surgery in patients undergoing parathyroidectomy. Thyroid, 2005, 15(9):1055-1059.
10. 徐少明, 郑毅雄, 王平, 等. 原发性甲状旁腺功能亢进症并发甲状腺疾病21例临床分析. 中华普通外科杂志, 2007, 22(2):81-84.
11. Sidhu S, Campbell P. Thyroid pathology associated with primary hyperparathyroidism. Aust N Z J Surg, 2000, 70(4):285-287.
12. Javadi H, Jallalat S, Farrokhi S, et al. Concurrent papillary thyroid cancer and parathyroid adenoma as a rare condition:a case report. Nucl Med Rev Cent East Eur, 2012, 15(2):153-155.
13. 崔爱民, 柏楠, 张自琴, 等. 原发性甲状旁腺功能亢进合并甲状腺病变的临床病因分析. 山东医药, 2011, 51(40):91-93.
14. Sturniolo G, Gagliano E, Tonante A, et al. Parathyroid carcinoma:case report. G Chir, 2013, 34(5-6):170-172.
15. 徐艺桐, 张观宇, 许立莉, 等. 无功能性甲状旁腺癌一例报道及文献复习. 中华临床医师杂志:电子版, 2012, 6(10):2807-2808.
16. 陈超, 陈红, 刘宝瑞, 等. 非功能性甲状旁腺癌1例. 临床肿瘤学杂志, 2011, 16(10):959-960.
17. Gao WC, Ruan CP, Zhang JC, et al. Nonfunctional parathyroid carcinoma. J Cancer Res Clin Oncol, 2010, 136(7):969-974.
18. Kebebew E, Arici C, Duh QY, et al. Localization and reoperation results for persistent and recurrent parathyroid carcinoma. Arch Surg, 2001, 136(8):878-885.
19. Sriphrapradang C, Sornmayura P, Chanplakorn N, et al. Fine-needle aspiration cytology of parathyroid carcinoma mimic hürthle cell thyroid neoplasm. Case Rep Endocrinol, 2014, 2014:680876.
20. Agarwal G, Dhingra S, Mishra SK, et al. Implantation of parathyroid carcinoma along fine needle aspiration track. Langenbecks Arch Surg, 2006, 391(6):623-626.
21. Delellis RA. Parathyroid carcinoma:an overview. Adv Anat Pathol, 2005, 12(2):53-61.
22. Schulte KM, Talat N. Diagnosis and management of parathyroid cancer. Nat Rev Endocrinol, 2012, 8(10):612-622.
23. Owen RP, Silver CE, Pellitteri PK, et al. Parathyroid carcinoma:a review. Head Neck, 2011, 33(3):429-436.
24. Campenni A, Ruggeri RM, Sindoni A, et al. Parathyroid carcinoma as a challenging diagnosis:report of three cases. Hormones (Athens), 2012, 11(3):368-376.
25. Montenegro FL, Chammas MC, Juliano AG, et al. Ethanol injection under ultrasound guidance to palliate unresectable parathyroid carcinoma. Arq Bras Endocrinol Metabol, 2008, 52(4):707-711.
26. Tochio M, Takaki H, Yamakado K, et al. A case report of 20 lung radiofrequency ablation sessions for 50 lung metastases from parathyroid carcinoma causing hyperparathyroidism. Cardiovasc Intervent Radiol, 2010, 33(3):657-659.
27. Shane E. Clinical review 122:parathyroid carcinoma. J Clin Endo-crinol Metab, 2001, 86(2):485-493.
28. 胡琳, 崔爱民, 柏楠, 等. 甲状旁腺癌的诊断和治疗(附7例报道). 中国普外基础与临床杂志, 2015, 22(1):75-80.
29. Kleinpeter KP, Lovato JF, Clark PB, et al. Is parathyroid carcinoma indeed a lethal disease?. Ann Surg Oncol, 2005, 12(3):260-266.

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