原发性甲状旁腺功能亢进患者的甲状腺偶发结节
Incidental thyroid nodules in patients with primary hyperparathyroidism.
作者信息
Phillips David J, Kutler David I, Kuhel William I
出版信息
Head Neck. 2014 Dec;36(12):1763-5. doi: 10.1002/hed.23533.
BACKGROUND
It is desirable to detect neoplastic thyroid disease before proceeding with surgical therapy for hyperparathyroidism so that both conditions can be treated with a single operation.
METHODS
Between March 1998 and June 2009, 227 patients with primary hyperparathyroidism were treated with surgical therapy. Of these, 217 were evaluated preoperatively with a modified 4-dimensional CT and ultrasonography. The medical records of these patients were reviewed in order to document the incidence and significance of thyroid pathology in this cohort of patients.
RESULTS
Thyroid nodules were identified in 159 of the 217 patients (73.3%). Nine of 217 patients (4.1%) were treated with either a partial or a total thyroidectomy at the time of parathyroidectomy. Three of these patients had papillary thyroid carcinoma, 1 had a Hurthle cell carcinoma, and 1 had an incidental micropapillary thyroid carcinoma.
CONCLUSION
The rate of clinically significant thyroid malignancy in patients undergoing surgical treatment of primary hyperparathyroidism was 1.8%.
背景
在对甲状旁腺功能亢进进行手术治疗之前，检测甲状腺肿瘤性疾病是可取的，这样两种疾病可以通过一次手术进行治疗。
方法
1998年3月至2009年6月期间，227例原发性甲状旁腺功能亢进患者接受了手术治疗。其中，217例患者术前接受了改良的四维CT和超声检查。回顾这些患者的病历，以记录该队列患者甲状腺病变的发生率和意义。
结果
217例患者中有159例（73.3%）发现甲状腺结节。217例患者中有9例（4.1%）在甲状旁腺切除时接受了部分或全甲状腺切除术。这些患者中有3例患有甲状腺乳头状癌，1例患有嗜酸性细胞癌，1例患有偶发性微小甲状腺乳头状癌。
结论
接受原发性甲状旁腺功能亢进手术治疗的患者中，具有临床意义的甲状腺恶性肿瘤发生率为1.8%。
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