Ishida Itaru, Oura Hiroyuki, Niikawa Hiromichi, Onodera Ken, Handa Masashi, Onuki Koji, Kawamura Minoru
Department of Thoracic Surgery, Iwate Prefectural Central Hospital, Morioka, Japan.
Kyobu Geka. 2012 Jun;65(6):466-9.
We report a case of a thymic carcinoid associated with multiple endocrine neoplasia type 1( MEN-1). A 37-year-old man was referred to our hospital for further examination of an abnormal chest shadow. A chest computed tomography (CT) showed an anterior mediastinal mass measuring 6.5 cm in diameter. A pathological diagnosis of thymic carcinoid was made from a CT-guided needle biopsy specimen. Preoperative workup including endocrinological examination revealed a pituitary adenoma and hyperparathyroidism, and MEN-1 was clinically diagnosed. We performed total parathyroidectomy with autotransplantation and thymectomy with lymph node dissection through cervical collar incision and median sternotomy. The diagnosis of MEN-1 was confirmed by the genomic analysis postoperatively. Since 25% of thymic carcinoids are MEN-1 related and 95% of MEN-1 patients develop hyperparathyroidism, it should be kept in mind that this condition can be treated by thymectomy and concurrent parathyroidectomy.
我们报告一例与1型多发性内分泌肿瘤（MEN-1）相关的胸腺类癌。一名37岁男性因胸部阴影异常被转诊至我院进一步检查。胸部计算机断层扫描（CT）显示前纵隔有一个直径6.5厘米的肿块。经CT引导下针吸活检标本作出胸腺类癌的病理诊断。包括内分泌检查在内的术前检查发现垂体腺瘤和甲状旁腺功能亢进，临床诊断为MEN-1。我们通过颈部领口切口和正中胸骨切开术进行了甲状旁腺全切术加自体移植以及胸腺切除术加淋巴结清扫。术后通过基因组分析确诊为MEN-1。由于25%的胸腺类癌与MEN-1相关，且95%的MEN-1患者会发生甲状旁腺功能亢进，应牢记这种情况可通过胸腺切除术和同期甲状旁腺切除术进行治疗。
