Thongtang Nuntakorn, Plengvidhaya Nattachet, Lertwattnarak Raweewan, Peepatdit Thavatchai
Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2007 Nov;90 Suppl 2:79-84.
Raw Cystic parathyroid adenoma is a rare cause of primary hyperparathyroidism. The authors report one case of cystic parathyroid adenoma, who presented with progressive right hip pain for one year. The patient had severe hypercalcemia at the first presentation and was misdiagnosed as having metastatic cancer at first. An iliac bone biopsy was performed and showed a giant cell tumor. Parathyroid hormone level was evaluated later and was found to be high, 1,555 pg/ml (15-65 pg/ml). An MRI study of the neck was done and revealed a cystic mass 38 x 36 x 40 mm in diameter just below the left lower pole of the thyroid gland. Tc-99m MIBI scan demonstrated increase and retention of radioactivity uptake at the same area. Hyperfunctioning parathyroid gland was considered. Parathyroidectomy was done and histopathology revealed cystic parathyroid adenoma. Serum calcium was normal and hip pain was markedly improved after the surgery.
未处理的囊性甲状旁腺腺瘤是原发性甲状旁腺功能亢进症的罕见病因。作者报告了一例囊性甲状旁腺腺瘤病例，该患者出现进行性右髋部疼痛一年。患者初诊时血钙严重升高，最初被误诊为转移性癌。进行了髂骨活检，结果显示为骨巨细胞瘤。后来评估甲状旁腺激素水平，发现其升高，为1555皮克/毫升（15 - 65皮克/毫升）。对颈部进行了MRI检查，发现甲状腺左下极下方有一个直径38×36×40毫米的囊性肿块。锝-99m甲氧基异丁基异腈扫描显示同一区域放射性摄取增加并滞留。考虑为甲状旁腺功能亢进。进行了甲状旁腺切除术，组织病理学显示为囊性甲状旁腺腺瘤。术后血清钙恢复正常，髋部疼痛明显改善。
