目的:总结和探讨甲状旁腺癌的诊断和治疗方法。方法:回顾性总结本院5例甲状旁腺癌的临床资料。结果:5例患者术前颈部均扪及质硬包块,平均血钙浓度为3.82 mmol/L,平均PTH浓度为153.6 pmol/L,4例术中发现周围浸润表现。5例中4例同时行甲状旁腺肿瘤和同侧甲状腺腺叶切除,1例仅行甲状旁腺肿瘤切除。5例术后均诊断为甲状旁腺癌。术后4例得到随访,时间4月~5年。其中2例术后无复发;1例于术后半年局部复发行患侧甲状腺切除,后无复发;1例因全身转移于术后8个月死亡。结论:甲状旁腺癌的诊断非常困难,异常高浓度血钙、血PTH及术中浸润表现和组织病理学特征是甲状旁腺癌诊断的重要依据,99m-Tc-MIBI扫描及超声是病变定位的首选手段,肿瘤及其周围受侵组织的“整块切除”(en bloc resection)是首选的治疗方式。
Citation:
ZHOU Yang,GONG Rixiang,LUO Shuhua,et al.. The Diagnosis and Treatment of Parathyroid Carcinoma. West China Medical Journal, 2009, 24(3): 579-581. doi:
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- 3. RAWAT N,KHETAN N,WILLIAMS DW,et al.Parathyroid carcinoma[J].B J Surg,2005,92(11):1345-1353..
- 4. MONTENEGRO FL,TAVARES MR,DURAZZO MD,et al.Clinical suspicion and parathyroid carcinoma management[J].Sao Paulo Med J,2006,124(1):42-44..
- 5. 周建平,田雨霖.中国人原发性甲状旁腺功能亢进10年文献回顾[J].中国普通外科杂志,2007,16(1):78-80..
- 6. ELIZABETH A,MITTENDOR F,MCHENRY CR.Parathyroid Carcinoma[J].Adv Anat Pathol,2005,12:53-61..
- 7. 李进,肖海鹏.甲状旁腺癌研究进展[J].国外医学杂志,2005,32(6):243-246,273..
- 8. KEBEBEW E.Parathyroid carcinoma[J].Curr Treat Options Oncol,2001,2:347-354..
- 9. FERNANDEZRANVIER GG,KHANAFSHAR E,JENSEN K,et al.Parathyroid carcinoma,atypical parathyroid adenoma,or parathyromatosis?[J]Cancer,2007,110(2):255-264..
- 10. THOMPSON SD,PRICHARD AJN.The management of parathyroid carcinoma[J].Curr Opin Otolaryngol Head Neck Surg,2004,12:93-97..
- 11. ERICKSON LA,LONG J,WOLLAR P,et al.Parathyroid hyperplasia,adenomas and carcinomas:differential expression of p27Kip1 protein[J].Am J Surg Pathol,1999,23:288-295..
- 12. STOJADINOVIC A,HOOS A,NISSAN A,et al.Parathyroid neoplasms:clinical,histopathological and tissue microarraybased molecular analysis[J].Hum Pathol,2003,34:54-64..
- 13. VASEF MA,BRYNES RK,STURM M,et al.Expression of cyclin D1 in parathyroid carcinomas,adenomas and hyperplasias[J].Mod Pathol,1999,12:412-416.