Luncă S, Stănescu C, Bouras G, Vix M, Marescaux J
IRCAD, University Hospital Strasbourg, France.
Chirurgia (Bucur). 2004 Nov-Dec;99(6):563-6.
About one quarter of patients with primary hyperparathyroidism have ectopic parathyroid tissue. The majority of parathyroid glands can be reached through a cervical approach, but in about 2% of the cases the ectopic gland is in the mediastinum in a location that requires a thoracic approach. Failure to remove ectopic mediastinal parathyroid tissue results in persistent hyperparathyroidism. Reoperative exploration for persistent hyperparathyroidism is often difficult even in the hands of experienced surgeons. Recent advances in preoperative localization techniques and intraoperative parathyroid hormone measurement have improved the rates of successful resection. We present a difficult case of persistent hyperparathyroidism secondary to an ectopic middle mediastinal parathyroid adenoma, which was eventually successfully managed in a specialised unit.
约四分之一的原发性甲状旁腺功能亢进患者存在异位甲状旁腺组织。大多数甲状旁腺可通过颈部入路触及，但约2%的病例中异位腺体位于纵隔，需要采用胸部入路。未能切除纵隔内异位甲状旁腺组织会导致持续性甲状旁腺功能亢进。即使是经验丰富的外科医生，对持续性甲状旁腺功能亢进进行再次手术探查也往往很困难。术前定位技术和术中甲状旁腺激素测量的最新进展提高了成功切除率。我们报告一例因纵隔中部异位甲状旁腺腺瘤导致的持续性甲状旁腺功能亢进的疑难病例，该病例最终在一个专科单位成功得到处理。
