Han Lu, Zhu Xiao-Feng
College of Medicine, Jiamusi University, Jiamusi 154000, Heilongjiang Province, China.
Department of Thoracic Surgery, The First Affiliated Hospital of Jiamusi University, Jiamusi 154000, Heilongjiang Province, China.
World J Clin Cases. 2020 Oct 6;8(19):4681-4687. doi: 10.12998/wjcc.v8.i19.4681.
Parathyroid adenoma is a benign parathyroid tumor, with serum parathyroid hormone and calcium ion concentrations as the typical basis for diagnosis. Its clinical manifestations are complex and changeable; thus it is easily missed or misdiagnosed. Approximately 85% of patients with parathyroid adenoma develop primary hyperparathyroidism, and abnormalities in bones, kidneys and other organs can occur. Brown tumors are rare.
We report a rare case of fibrocystic osteitis associated with a parathyroid adenoma, which was discovered by chance due to a rib tumor. Abnormally elevated serum parathyroid hormone and calcium ion were found before surgery. We suspected primary hyperparathyroidism, and color Doppler ultrasound suggested the presence of a thyroid mass. With informed consent by the patient and her family, we first removed the rib tumor, and one week later, resection of the parathyroid adenoma and thyroid mass was performed on both sides, and the patient recovered well after surgery.
In the case of parathyroid adenoma combined with brown tumor, the bone cyst will gradually decrease in size with time without treatment. If not, surgery should be performed as soon as possible.
甲状旁腺腺瘤是一种良性甲状旁腺肿瘤，以血清甲状旁腺激素和钙离子浓度作为典型诊断依据。其临床表现复杂多变，易漏诊或误诊。约85%的甲状旁腺腺瘤患者会发生原发性甲状旁腺功能亢进，可出现骨骼、肾脏等器官异常。棕色瘤较为少见。
我们报告1例与甲状旁腺腺瘤相关的纤维囊性骨炎罕见病例，该病例因肋骨肿瘤偶然发现。术前发现血清甲状旁腺激素和钙离子异常升高。我们怀疑为原发性甲状旁腺功能亢进，彩色多普勒超声提示甲状腺有肿物。在患者及其家属知情同意后，我们首先切除肋骨肿瘤，1周后双侧切除甲状旁腺腺瘤及甲状腺肿物，术后患者恢复良好。
对于甲状旁腺腺瘤合并棕色瘤的病例，骨囊肿未经治疗会随时间逐渐缩小，否则应尽早手术。
