Kaszczewska Monika, Chudziński Witold, Kaszczewski Piotr, Popow Michał, Grzybowski Jakub, Skowrońska-Szcześniak Anna, Kozubek Herbert, Gałązka Zbigniew
Department of General, Vascular, Endocrine and Transplantation Surgery, Medical University of Warsaw, 02-097 Warsaw, Poland.
Department of Endocrinology and Internal Medicine, Medical University of Warsaw, 02-097 Warsaw, Poland.
J Clin Med. 2023 Jul 27;12(15):4939. doi: 10.3390/jcm12154939.
(1) Background: Parathyroid cystic adenomas (PCA) are rare entities representing only 0.5-1% of parathyroid adenomas, accounting for 1-2% of cases of primary hyperparathyroidism (PHPT). The purpose of this study was to compare classical and functional/secreting cystic parathyroid lesions and identify risk factors for severe hypercalcemia; (2) Methods: A total of 17 patients with PHPT and parathyroid cysts (study group) were compared with the group of 100 patients with hyperparathyroidism caused by adenoma or hyperplasia (control group). In both groups the majority were women (88% vs. 12%, with gender ratio 7, 3:1). The patients were examined preoperatively and postoperatively: PTH, creatine, calcium and phosphate serum and urine concentrations and calcidiol serum levels were assessed; (3) Results: Patients with parathyroid cyst had statistically higher PTH and calcium serum concentration, higher calciuria and lower serum phosphate concentration. There were no statistically significant differences in the concentration of creatine in serum and urine and tubular reabsorption of phosphorus (TRP); (4) Conclusions: Due to higher PTH and calcium levels, cystic parathyroid adenomas could be one of the rare risk factors for severe hypercalcemia and hypercalcemic crisis which can be life threatening.
(1) 背景：甲状旁腺囊性腺瘤（PCA）较为罕见，仅占甲状旁腺腺瘤的0.5 - 1%，占原发性甲状旁腺功能亢进症（PHPT）病例的1 - 2%。本研究的目的是比较经典型和功能性/分泌性甲状旁腺囊性病变，并确定严重高钙血症的危险因素；(2) 方法：将17例患有PHPT和甲状旁腺囊肿的患者（研究组）与100例由腺瘤或增生引起的甲状旁腺功能亢进患者（对照组）进行比较。两组中大多数为女性（88%对12%，性别比为7.3:1）。对患者进行术前和术后检查：评估血清和尿液中的甲状旁腺激素（PTH）、肌酐、钙和磷浓度以及血清骨化二醇水平；(3) 结果：甲状旁腺囊肿患者的血清PTH和钙浓度在统计学上更高，尿钙更高，血清磷浓度更低。血清和尿液中的肌酐浓度以及磷的肾小管重吸收（TRP）没有统计学上的显著差异；(4) 结论：由于PTH和钙水平较高，甲状旁腺囊性腺瘤可能是严重高钙血症和高钙血症危象这一危及生命情况的罕见危险因素之一。
