病例报告：原发性甲状旁腺功能亢进症与毒性巨大结节性甲状腺肿共存。
Case report: coexistence of primary hyperparathyroidism with giant toxic nodular goiter.
机构信息
Department of Endocrinology, The First Medical Center of PLA General Hospital, 100853, Beijing, China.
Department of Endocrinology, Affiliated People's Hospital, Zhejiang Provincial People's Hospital, Hangzhou Medical College, Zhejiang Province, 310003, Hangzhou, China.
出版信息
BMC Endocr Disord. 2022 Aug 9;22(1):200. doi: 10.1186/s12902-022-01117-0.
BACKGROUND
The coexistence of primary hyperparathyroidism (PHPT) and giant toxic nodular goiter is very rare. Moreover, PHPT could be easily overlooked because hyperthyroidism may also lead to hypercalcemia. A 99mTc-MIBI scan of the parathyroid glands is often negative when they are concomitant.
CASE PRESENTATION
Here, we report a rare case of the coexistence of giant toxic nodular goiter and PHPT that had been ignored for many years but was successfully treated with an ultrasound-guided parathyroid adenoma microwave ablation (MWA).
CONCLUSION
Reoperation for PHPT carries an increased risk of cure failure and complications. Thermal ablation has been proven effective in inactivating hyperfunctioning parathyroid lesions and in normalizing both serum parathyroid hormone (PTH) and calcium.
背景
原发性甲状旁腺功能亢进症（PHPT）与毒性巨大结节性甲状腺肿同时存在的情况非常罕见。此外，由于甲状腺功能亢进症也可能导致高钙血症，因此 PHPT 很容易被忽视。当它们同时存在时，甲状旁腺的 99mTc-MIBI 扫描通常为阴性。
病例介绍
本文报告了一例罕见的毒性巨大结节性甲状腺肿和 PHPT 同时存在的病例，这些年一直被忽视，但通过超声引导下甲状旁腺瘤微波消融（MWA）治疗获得了成功。
结论
对于 PHPT 的再次手术治疗存在治疗失败和并发症增加的风险。热消融已被证明能有效灭活功能亢进的甲状旁腺病变，并使甲状旁腺激素（PTH）和血清钙正常化。
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