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胸腔镜手术治疗异位胸腺甲状旁腺腺瘤

Thoracoscopic approach in the treatment of ectopic thymic parathyroid adenoma.

作者信息

Beiša Virgilijus, Pranskevičiūtė Neringa, Makūnaitė Gabija, Strupas Kęstutis

机构信息

Centre of Abdominal Surgery, Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.

出版信息

Wideochir Inne Tech Maloinwazyjne. 2018 Jun;13(2):270-277. doi: 10.5114/wiitm.2018.73331. Epub 2018 Feb 7.

DOI:10.5114/wiitm.2018.73331
PMID:30002763
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6041573/
Abstract

Primary hyperparathyroidism is overproduction of parathyroid hormone, causing hypercalcemia. Parathyroid adenomas have been found to be the etiology for 80% of cases of primary hyperparathyroidism, while almost a quarter of them are ectopic. We present a case of ectopic thymic parathyroid adenoma, treated by the thoracoscopic approach. Preoperative computed tomogram and technetium-99-sestamibi imaging showed an adenoma, located in the front mid-mediastinum, approximately 8 × 10 mm in size. Resection of the tumor was indicated according to the persistent hypercalcemia after unsuccessful surgical treatment performed 3 years ago. It was decided to perform a parathyroidectomy during thoracoscopy. The diagnosis of parathyroid adenoma was established on postoperative histopathology staining. The patient was discharged from hospital 5 days after the surgery. We found this minimally invasive operation to be an effective and well-tolerated treatment option, determined by the experience of the surgeon.

摘要

原发性甲状旁腺功能亢进是甲状旁腺激素分泌过多，导致高钙血症。甲状旁腺腺瘤是80%原发性甲状旁腺功能亢进病例的病因，其中近四分之一为异位性。我们报告1例经胸腔镜手术治疗的异位胸腺甲状旁腺腺瘤病例。术前计算机断层扫描和锝-99-甲氧基异丁基异腈显像显示一个位于前纵隔中部、大小约8×10 mm的腺瘤。根据3年前手术治疗失败后持续存在的高钙血症，决定切除肿瘤。决定在胸腔镜检查期间进行甲状旁腺切除术。术后组织病理学染色确诊为甲状旁腺腺瘤。患者术后5天出院。根据外科医生的经验，我们发现这种微创手术是一种有效且耐受性良好的治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf52/6041573/4915b5f028b8/WIITM-13-31750-g009.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf52/6041573/5df3b9a29e4d/WIITM-13-31750-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf52/6041573/4915b5f028b8/WIITM-13-31750-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf52/6041573/63c1d9065839/WIITM-13-31750-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf52/6041573/167db087e1d6/WIITM-13-31750-g002.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf52/6041573/fc7de857c1ad/WIITM-13-31750-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf52/6041573/ad8bde0fcae5/WIITM-13-31750-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf52/6041573/4169b3ff5583/WIITM-13-31750-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf52/6041573/dbe2ac7d3462/WIITM-13-31750-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf52/6041573/5df3b9a29e4d/WIITM-13-31750-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf52/6041573/4915b5f028b8/WIITM-13-31750-g009.jpg

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本文引用的文献

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Comparative Effectiveness of Ultrasonography, 99mTc-Sestamibi, and 18F-Fluorocholine PET/CT in Detecting Parathyroid Adenomas in Patients With Primary Hyperparathyroidism.超声、99mTc-甲氧基异丁基异腈和 18F-氟代胆碱 PET/CT 在原发性甲状旁腺功能亢进症患者甲状旁腺瘤检测中的比较效果。
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