1University of Split, Split University Hospital Center, Department of Otorhinolaryngology, Split, Croatia; 2University of Split, Split University Hospital Center, Department of Endocrinology, Split, Croatia.
Acta Clin Croat. 2020 Jun;59(Suppl 1):96-101. doi: 10.20471/acc.2020.59.s1.12.
We present the case of a 48-year-old male patient who underwent surgery for a recurrent metastatic parathyroid gland carcinoma in the patient's right paratracheal space of the neck. The patient had undergone surgery for lower right parathyroid gland carcinoma 28 months earlier.
The metastases were resected with an ipsilateral central neck dissection and with the removal of the enlarged lower left parathyroid gland. After exploration of the remnant parathyroid glands we noticed that lower left parathyroid gland was macroscopically enlarged so we decided to remove it to prevent possible hypercalcemia in future and to also prevent possible recurrence of cancer or development of a new primary, considering the identical embryological origin of the lower parathyroid glands and possibility of synchronous, multiple tumors, which generally follow the same embryological origin if they occur. The patient was also treated with radiation therapy after the surgery.
With the present surgical approach to recurrent metastatic parathyroid gland carcinoma, we aimed to prevent the recurrence of cancer or development of new primary and prevent or delay hypercalcemia in the future with all severe adverse metabolic states associated with high serum calcium levels.
我们报告 1 例 48 岁男性患者，该患者因右侧颈部气管旁复发转移性甲状旁腺癌接受手术治疗。28 个月前，该患者曾因右下甲状旁腺癌接受过手术治疗。
通过同侧中央颈部清扫术和切除增大的左下甲状旁腺切除转移灶。探查残余甲状旁腺时，我们注意到左下甲状旁腺明显肿大，因此决定将其切除，以防止未来可能发生高钙血症，并考虑到下甲状旁腺具有相同的胚胎起源，以及可能存在同步、多发性肿瘤，若发生则通常遵循相同的胚胎起源，从而预防癌症的复发或新原发性肿瘤的发生。术后患者还接受了放射治疗。
通过目前治疗复发性转移性甲状旁腺癌的手术方法，我们旨在预防癌症的复发或新原发性肿瘤的发生，并预防或延迟未来可能发生的高钙血症，以及所有与高血清钙水平相关的严重代谢不良状态。
