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[甲状旁腺癌的意外术后诊断]

[Unexpected Postoperative Diagnosis of Parathyroid Carcinoma].

作者信息

Litzel Martin, Henzen Christoph, Fourie Lana, Fischli Stefan

机构信息

Abteilung Endokrinologie, Diabetologie und klinische Ernährung, Luzerner Kantonsspital Luzern.

Abteilung für Allgemein- und Viszeralchirurgie, Luzerner Kantonsspital Luzern.

出版信息

Praxis (Bern 1994). 2020;109(4):291-296. doi: 10.1024/1661-8157/a003388.

Abstract

Unexpected Postoperative Diagnosis of Parathyroid Carcinoma Parathyroid carcinoma is a rare endocrine malignancy. It typically presents itself with similar clinical features as seen in patients with primary hyperparathyroidism caused by a parathyroid adenoma. Due to overlapping clinical manifestations, imaging findings and pathological characteristics, the differentiation between benign and malignant parathyroid disease poses a diagnostic challenge, especially prior to surgery. We report the case of a 67-year-old male who presented with symptomatic hypercalcemia and primary hyperparathyroidism. During resection of the enlarged parathyroid gland, suspicious macroscopic features were noticed and the histopathology finding confirmed the malignancy. Parathyroid carcinoma is rarely diagnosed preoperatively, which is mainly due to the lack of distinctive symptoms or morphological features suggesting a malignant disease. As parathyroid carcinoma often has a genetic background, knowledge of mutation status and family history is of high relevance. Surgery with complete resection of the parathyroid carcinoma is the mainstay for a successful treatment and a good prognosis.

摘要

甲状旁腺癌的意外术后诊断 甲状旁腺癌是一种罕见的内分泌恶性肿瘤。它通常表现出与甲状旁腺腺瘤引起的原发性甲状旁腺功能亢进患者相似的临床特征。由于临床表现、影像学表现和病理特征相互重叠,良性和恶性甲状旁腺疾病的鉴别诊断具有挑战性,尤其是在手术前。我们报告一例67岁男性,表现为有症状的高钙血症和原发性甲状旁腺功能亢进。在切除肿大的甲状旁腺时,注意到可疑的宏观特征,组织病理学检查结果证实为恶性。甲状旁腺癌术前很少被诊断出来,这主要是由于缺乏提示恶性疾病的独特症状或形态特征。由于甲状旁腺癌通常有遗传背景,了解突变状态和家族史具有高度相关性。手术完全切除甲状旁腺癌是成功治疗和良好预后的主要方法。

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