Gauhar Tooba Mahmud, Shahzad Noman, Mahmud Tayyaba, Khwaja Muhammad Azim
East Surgical Ward, Mayo Hospital, Lahore.
J Coll Physicians Surg Pak. 2012 Dec;22(12):789-91.
Parathyroid carcinoma is a rare cause of hypercalcaemia due to primary hyperparathyroidism. Ninety five percent of parathyroid carcinomas are functional tumours. Surgery is the only potential curative treatment. This is a case of a 53 years lady, who presented with pathological fracture of femur, hypercalcaemia, deranged renal functions, change in voice, difficulty in swallowing and markedly raised parathormone levels. Doppler ultrasound localized an irregular mass at right lower gland. SESTAMIBI scan showed probability of adenoma in the region of right lower thyroid pole. Intra-operatively, tumour was found stuck to esophagus and right recurrent laryngeal nerve passing through it. Enlarged parathyroid gland was removed in toto along with the recurrent laryngeal nerve, right thyroid lobe and its isthmus.
甲状旁腺癌是原发性甲状旁腺功能亢进导致高钙血症的罕见病因。95%的甲状旁腺癌为功能性肿瘤。手术是唯一可能治愈的治疗方法。这是一例53岁女性患者,表现为股骨病理性骨折、高钙血症、肾功能紊乱、声音改变、吞咽困难以及甲状旁腺激素水平显著升高。多普勒超声在右下甲状旁腺发现一个不规则肿块。锝[99mTc]甲氧基异丁基异腈扫描显示右下甲状腺极区有腺瘤的可能性。术中发现肿瘤与食管粘连,右侧喉返神经穿过肿瘤。连同喉返神经、右甲状腺叶及其峡部一并完整切除肿大的甲状旁腺。