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继发性甲状旁腺功能亢进症合并甲状腺半侧发育不全患者的甲状旁腺癌:病例报告及文献复习

Parathyroid Carcinoma in a Patient With Secondary Hyperparathyroidism and Thyroid Hemiagenesis: A Case Report and Review of the Literature.

作者信息

Kada Shinpei, Tanaka Miho, Yasoda Akihiro

机构信息

Department of Otolaryngology-Head and Neck Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.

Department of Otolaryngology-Head and Neck Surgery, Otsu Red Cross Hospital, Otsu, Shiga, Japan.

出版信息

Ear Nose Throat J. 2024 Jan;103(1):NP25-NP30. doi: 10.1177/01455613211036240. Epub 2021 Jul 28.

Abstract

Parathyroid carcinoma is a rare endocrine tumor. Parathyroid carcinoma in patients with secondary hyperparathyroidism due to chronic kidney disease is also rare. In addition, thyroid hemiagenesis is a rare congenital anomaly. We report an extremely rare case of parathyroid carcinoma in a patient with secondary hyperparathyroidism and thyroid hemiagenesis. We also present a review of the literature of this rare entity. We also discuss the surgical procedure performed for this patient. Our review of the literature found 34 case reports of parathyroid carcinoma in patients undergoing dialysis due to chronic renal failure; 14 reports of thyroid hemiagenesis with parathyroid disease; and no previous reports of thyroid hemiagenesis with secondary hyperparathyroidism and parathyroid carcinoma. Although surgical treatment of parathyroid carcinoma requires combined resection with the thyroid, peritracheal dissection with total parathyroidectomy, and monitoring intact parathyroid hormone as a tumor marker, our procedure preserved the patient's thyroid function. There has been no evidence of recurrence for over 8 years.

摘要

甲状旁腺癌是一种罕见的内分泌肿瘤。因慢性肾病导致继发性甲状旁腺功能亢进的患者发生甲状旁腺癌也很罕见。此外,甲状腺半侧缺如是一种罕见的先天性异常。我们报告了一例极为罕见的病例,患者患有继发性甲状旁腺功能亢进和甲状腺半侧缺如,却发生了甲状旁腺癌。我们还对该罕见病例进行了文献综述。我们也讨论了为该患者实施的手术过程。我们的文献综述发现,有34例慢性肾衰竭透析患者发生甲状旁腺癌的病例报告;14例甲状腺半侧缺如合并甲状旁腺疾病的报告;而此前没有甲状腺半侧缺如合并继发性甲状旁腺功能亢进和甲状旁腺癌的报告。尽管甲状旁腺癌的手术治疗需要联合切除甲状腺、进行气管周围解剖并全甲状旁腺切除术,以及监测完整甲状旁腺激素作为肿瘤标志物,但我们的手术保留了患者的甲状腺功能。8年多来一直没有复发的迹象。

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