Department of Endocrinology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
Present address: Department of Endocrinology, Renmin Hospital of Wuhan University, Jiefang Road 238, Wuhan, Hubei, 430060, China.
BMC Endocr Disord. 2023 Jun 6;23(1):130. doi: 10.1186/s12902-023-01363-w.
Parathyroid carcinoma (PC) is an uncommon cause of primary hyperparathyroidism (PHPT) and particularly rare in the mediastinum. Herein, we present a case of mediastinal PC and conduct a related literature review.
We described a case of a 50-year-old female patient with PHPT due to mediastinal PC. She was initially admitted to a local hospital in her hometown with hypercalcemia and high blood concentrations of PTH (parathyroid hormone). The patient underwent neck parathyroidectomy and pathological examination suggested parathyroid adenoma. Although the overproduction of serum calcium and PTH declined after the surgery, calcium and PTH increased again one month later, so the patient was transferred to our hospital. A 99Tc-sestamibi scan revealed an ectopic finding in the mediastinum, which was also indicated on the CT image. After removing the mediastinal mass, the metabolism of calcium and PTH quickly reverted to normal and the pathologic features of the mass were consistent with PC. By reviewing the related literature, we noticed that only scattered reports were published before 1982, and those were not included in the present review due to their differences with current radiological examination and treatment methods. After excluding outdated studies, we summarized and analyzed 20 reports of isolated mediastinal PC and concluded that. Parathyroidectomy remains the only curative treatment for the disease. Furthermore, the success of treatment directly depends on accurate preoperative localization.
With this study, we emphasize the importance of accurate preoperative diagnosis of mediastinal PC and improve clinicians' understanding of the disease.
甲状旁腺癌（PC）是原发性甲状旁腺功能亢进症（PHPT）的罕见病因，尤其在纵隔中罕见。在此，我们报告一例纵隔 PC 病例，并进行相关文献复习。
我们描述了一例 50 岁女性因纵隔 PC 导致 PHPT 的病例。她最初因高钙血症和甲状旁腺激素（PTH）的高血浓度而被收入家乡的一家当地医院。患者接受了颈部甲状旁腺切除术，病理检查提示甲状旁腺腺瘤。尽管手术后血清钙和 PTH 的过度产生下降，但一个月后钙和 PTH 再次升高，因此患者被转至我们医院。99Tc-甲氧基异丁基异腈扫描显示纵隔异位发现，CT 图像也显示了这一点。切除纵隔肿块后，钙和 PTH 的代谢迅速恢复正常，肿块的病理特征与 PC 一致。通过复习相关文献，我们注意到 1982 年前仅发表了散在的报告，由于与当前放射检查和治疗方法的差异，这些报告未包含在本次综述中。排除过时的研究后，我们总结和分析了 20 例孤立性纵隔 PC 的报告，得出结论：甲状旁腺切除术仍然是该疾病的唯一治愈性治疗方法。此外，治疗的成功直接取决于准确的术前定位。
通过本研究，我们强调了准确术前诊断纵隔 PC 的重要性，并提高了临床医生对该疾病的认识。
