Krishnamurthy Arvind, Raghunandan Gorantlu Chowdappa, Ramshankar Vijayalakshmi
Department of Surgical Oncology, Cancer Institute (WIA), Chennai, Tamil Nadu, India.
Department of Preventive Oncology, Cancer Institute (WIA), Chennai, Tamil Nadu, India.
Indian J Nucl Med. 2016 Jan-Mar;31(1):36-8. doi: 10.4103/0972-3919.172355.
Parathyroid adenomas are usually small in size; (weighing 70 mg-1 g) those weighing more than 2-3 g are classified as giant parathyroid adenomas. Giant parathyroid adenomas are in fact rarely encountered among patients with primary hyperparathyroidism. They are believed to have distinct clinical and biochemical features related to specific genomic alterations. We chanced to manage a unique and possibly the first case of giant parathyroid adenoma (6 cm diameter and weighing 20 g) presenting with recurrent episodes of pancreatitis and discuss its surgical management with an added emphasis on the role of nuclear imaging in its preoperative localization. Our case demonstrates that clinicians should have a high index of suspicion of primary hyperparathyroidism in patients presenting with recurrent episodes of pancreatitis. Timely diagnosis, appropriate preoperative localization techniques, which would include a parathyroid scintigraphy and a focused surgical intervention are crucial to resolve complications and improve outcomes.
甲状旁腺腺瘤通常体积较小（重70毫克至1克）；重量超过2 - 3克的则被归类为巨大甲状旁腺腺瘤。事实上，巨大甲状旁腺腺瘤在原发性甲状旁腺功能亢进患者中很少见。据信它们具有与特定基因组改变相关的独特临床和生化特征。我们偶然处理了一例独特且可能是首例的巨大甲状旁腺腺瘤（直径6厘米，重20克），该患者伴有复发性胰腺炎发作，并讨论了其手术管理，特别强调了核成像在其术前定位中的作用。我们的病例表明，临床医生对出现复发性胰腺炎发作的患者应高度怀疑原发性甲状旁腺功能亢进。及时诊断、适当的术前定位技术（包括甲状旁腺闪烁显像和有针对性的手术干预）对于解决并发症和改善预后至关重要。
