Du Hailei, Shi Minmin, Zhu Lianggang, Che Jiamin, Hang Junbiao, Chen Zhongyuan, Li Hecheng
Department of thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
Institute of Digestive Surgery, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
J Thorac Dis. 2017 Dec;9(12):5171-5175. doi: 10.21037/jtd.2017.11.60.
To investigate the therapeutic effect of different surgical treatment for ectopic mediastinal parathyroid tumors and pathological features.
A total of 21 patients who were diagnosed with ectopic mediastinal parathyroid tumors and underwent surgeries in our department from May 1995 to May 2015 were collected and retrospectively analyzed.
Twenty-one patients including 8 female (36.4%) and 13 male (63.6%) were collected. Among these patients, 9 cases were treated with video-assisted thoracic surgery (VATS), while 13 cases were treated with open surgery (including one secondary open operation after thoracoscopic operation). The average size of mediastinal tumors was 2.17±1.22 cm. For the post-operational pathology, 16 cases (76.2%) were diagnosed as ectopic parathyroid adenoma; 4 cases (19.0%) were diagnosed as parathyroid hyperplasia, while only 1 case (4.8%) was diagnosed as parathyroid adenocarcinoma.
Parathyroid adenoma accounts for the major pathological type of ectopic mediastinal parathyroid tumors. In addition, the correct diagnosis with precise preoperative location was the key for the treatment of ectopic mediastinal parathyroid tumors accompanied with hyperparathyroidism. Surgical intervention was demonstrated to be an effective way for the treatment of ectopic mediastinal parathyroid tumors with satisfied therapeutic outcome, especially for the VATS due to its unique clinical advantages. However, there may some difficulties when locating ectopic mediastinal parathyroid tumor less than 1 cm and the operators should be very cautious when performing thoracoscopic operations.
探讨不同手术治疗方法对异位纵隔甲状旁腺肿瘤的治疗效果及病理特征。
收集1995年5月至2015年5月在我科诊断为异位纵隔甲状旁腺肿瘤并接受手术的21例患者，进行回顾性分析。
共收集21例患者，其中女性8例（36.4%），男性13例（63.6%）。这些患者中，9例接受了电视辅助胸腔镜手术（VATS），13例接受了开放手术（包括1例胸腔镜手术后的二次开放手术）。纵隔肿瘤的平均大小为2.17±1.22 cm。术后病理检查，16例（76.2%）诊断为异位甲状旁腺腺瘤；4例（19.0%）诊断为甲状旁腺增生，仅1例（4.8%）诊断为甲状旁腺癌。
甲状旁腺腺瘤是异位纵隔甲状旁腺肿瘤的主要病理类型。此外，正确诊断并精确术前定位是治疗伴有甲状旁腺功能亢进的异位纵隔甲状旁腺肿瘤的关键。手术干预被证明是治疗异位纵隔甲状旁腺肿瘤的有效方法，治疗效果满意，尤其是VATS因其独特的临床优势。然而，定位小于1 cm的异位纵隔甲状旁腺肿瘤可能存在一些困难，术者在进行胸腔镜手术时应非常谨慎。
