Triantafyllidou Maria, Strobel Klaus, Leiser Alfred, Fischli Stefan
Division of Endocrinology, Diabetes and Clinical Nutrition, Luzerner Kantonsspital, Luzern, Switzerland.
Department of Radiology and Nuclear Medicine, Luzerner Kantonsspital, Luzern, Switzerland.
BMJ Case Rep. 2018 Mar 28;2018:bcr-2017-222089. doi: 10.1136/bcr-2017-222089.
We report the case of two patients with newly diagnosed primary hyperparathyroidism: a 40-year-old woman during pregnancy and a 60-year-old man with initial hypercalcaemic crisis. In the first case, a bilateral neck exploration with parathyroidectomy during the second trimester of pregnancy was unsuccessful and the patient remained hypercalcaemic. Postpartum imaging assessment with technetium (Tc)-sestamibi scintigraphy could not supply conclusive diagnostic results. The use of F-fluorocholine (FCH) positron emission tomography (PET)/CT provided the accurate localisation of an ectopic parathyroid adenoma in the anterior mediastinum which was successfully resected by a thoracoscopic approach. In the second case, Tc-sestamibi scintigraphy was inconclusive as well and FCH-PET/CT localised an ectopic parathyroid adenoma in the mediastinum and thus bilateral neck exploration could be spared. Both patients had surgical cure of their disease.
一例是孕期40岁的女性，另一例是初始表现为高钙血症危象的60岁男性。第一例患者在妊娠中期进行了双侧颈部探查及甲状旁腺切除术，但手术未成功，患者仍存在高钙血症。产后用锝（Tc）- sestamibi闪烁扫描进行影像学评估未能提供明确的诊断结果。使用F-氟胆碱（FCH）正电子发射断层扫描（PET）/CT准确地定位了前纵隔内的异位甲状旁腺腺瘤，该腺瘤通过胸腔镜手术成功切除。第二例患者，Tc-sestamibi闪烁扫描结果也不明确，FCH-PET/CT定位了纵隔内的异位甲状旁腺腺瘤，从而避免了双侧颈部探查。两名患者均通过手术治愈了疾病。
