Falcetta Pierpaolo, Cetani Filomena, Tonacchera Massimo
Department of Clinical and Experimental Medicine, Section of Endocrinology, University Hospital of Pisa, Pisa, Italy.
Endocrinology Unit 2, University Hospital of Pisa, Pisa, Italy.
AACE Clin Case Rep. 2020 Dec 28;7(1):75-79. doi: 10.1016/j.aace.2020.11.021. eCollection 2021 Jan-Feb.
Spontaneous or fine-needle aspiration biopsy (FNAB)-induced remission of primary hyperparathyroidism (PHPT) is an extremely rare and generally transient phenomenon.
A 40-year-old woman with a history of recurrent kidney stones was diagnosed with PHPT (serum calcium, 14.2 mg/dL; parathyroid hormone [PTH], 380 pg/mL). Ultrasonography and scintigraphy findings were consistent with a left enlarged parathyroid. Ultrasound-guided-FNAB cytology of the lesion did not confirm a parathyroid nature. However, levels of PTH within the needle-washing fluid were elevated.
After few days, there was evidence of biochemical remission of the hypercalcemia (calcium, 8.1 mg/dL), and at subsequent follow-up visits, the enlarged parathyroid showed progressive shrinkage with eucalcemia and normalized PTH levels throughout 12 months of follow-up.
Rarely, remission of PHPT may occur after ultrasound-guided-FNAB performed on a hyperfunctioning parathyroid lesion.
原发性甲状旁腺功能亢进症（PHPT）自发缓解或经细针穿刺活检（FNAB）诱导缓解是一种极其罕见且通常为短暂性的现象。
一名有复发性肾结石病史的40岁女性被诊断为PHPT（血清钙，14.2mg/dL；甲状旁腺激素[PTH]，380pg/mL）。超声检查和闪烁扫描结果与左侧甲状旁腺肿大一致。对该病变进行超声引导下FNAB细胞学检查未证实为甲状旁腺性质。然而，针洗液中的PTH水平升高。
几天后，有高钙血症生化缓解的证据（钙，8.1mg/dL），在随后的随访中，肿大的甲状旁腺逐渐缩小，血钙正常，PTH水平在整个12个月的随访期间恢复正常。
罕见情况下，对功能亢进的甲状旁腺病变进行超声引导下FNAB后，PHPT可能会缓解。
