Wei J P, Tippins R B, Rao R N, Burke G J, Mansberger A R
Section of Endocrine Surgery, Medical College of Georgia, Augusta 30912.
South Med J. 1994 Dec;87(12):1264-8. doi: 10.1097/00007611-199412000-00011.
Primary hyperparathyroidism may be caused by ectopic intrathymic parathyroid adenomas or hyperplastic parathyroid glands. The association of the ectopic inferior parathyroid glands and the thymus is due to their common embryologic origin from the third pharyngeal pouch. We report a case of primary hyperparathyroidism due to an unusual pathologic parathyroid gland formation: nonadenomatous thymic unencapsulated parathyroid tissue. Two unsuccessful neck exploration revealed only two normal parathyroid glands within the cervical area. Radiologic imaging studies failed to localize an ectopic parathyroid adenoma. Mediastinal exploration and thymectomy showed one small focus of unencapsulated hypercellular parathyroid tissue expanding peripherally along the septa of thymic adipose tissue. The hyperparathyroidism resolved with the surgical procedure.
原发性甲状旁腺功能亢进可能由异位胸腺内甲状旁腺腺瘤或甲状旁腺增生引起。异位下甲状旁腺与胸腺的关联是由于它们共同起源于第三咽囊的胚胎学原因。我们报告一例原发性甲状旁腺功能亢进病例，其病因是一种不寻常的病理性甲状旁腺形成：非腺瘤性胸腺未被膜包裹的甲状旁腺组织。两次颈部探查均未成功，仅在颈部区域发现两个正常甲状旁腺。影像学检查未能定位异位甲状旁腺腺瘤。纵隔探查及胸腺切除术显示一个未被膜包裹的高细胞甲状旁腺组织小病灶，沿胸腺脂肪组织间隔向周边扩展。手术治疗后甲状旁腺功能亢进得以缓解。
