Avramides A, Papamargaritis K, Antoniadis A, Gakis D, Leontsini M
Department of Endocrinology, Hippokration Hospital, Thessaloniki, Greece.
J Endocrinol Invest. 1992 Jan;15(1):39-42. doi: 10.1007/BF03348653.
Parathyroid carcinoma is a rare tumor responsible for 0.5-5% of primary hyperparathyroidism. It is usually small (not more than 27 g) and the precise diagnosis of malignancy is made when local or distant metastases are found. We describe a case of a 37 yr old male presenting with a substernal goiter and no specific symptoms except hypertension. This mass had cysts and calcifications and it was in the anterior upper mediastinum. The patient had severe hypercalcemia (Ca greater than 14 mg/dl), high PTH levels and mild renal failure. Bone scanning showed signs of hyperparathyroidism. The patient was subjected to total thyroidectomy and removal of the mass en block. The tumor was circumscribed lobulated and mostly cystic. It weighed 1,200 g (380 g after evacuation of cysts) and measured 12 x 9 x 4.5 cm. Histologic examination showed a highly differentiated adenocarcinoma of parathyroid with metastasis in a regional lymph node. Almost 4 years later the patient is alive and well without hypercalcemia and without evidence of distant metastases.
甲状旁腺癌是一种罕见肿瘤，占原发性甲状旁腺功能亢进症的0.5% - 5%。它通常体积较小（不超过27克），当发现局部或远处转移时才能做出恶性肿瘤的准确诊断。我们描述了一例37岁男性患者，表现为胸骨后甲状腺肿，除高血压外无特定症状。该肿物有囊肿和钙化，位于前上纵隔。患者有严重高钙血症（血钙大于14毫克/分升）、高甲状旁腺激素水平及轻度肾衰竭。骨扫描显示甲状旁腺功能亢进迹象。患者接受了甲状腺全切及肿物整块切除。肿瘤边界清晰，呈分叶状，大部分为囊性。其重量为1200克（囊肿排空后为380克），大小为12×9×4.5厘米。组织学检查显示为高分化甲状旁腺癌，区域淋巴结有转移。近4年后，患者存活且状况良好，无高钙血症，也无远处转移迹象。
