Duh Q Y, Ciulla T A, Clark O H
Surgical Service, Veterans Affairs Medical Center, San Francisco, Calif. 94121.
Surgery. 1994 Feb;115(2):257-63.
Congenital thyroid anomalies can be caused by abnormal descent or agenesis of part of the thyroid gland. Agenesis of the thyroid gland may involve one or both lobes of the gland, with or without isthmus, and is very rare. Congenital thyroid anomalies have been reported to be associated with thyroid diseases (hyperthyroidism, adenomatous goiter, and cancer) but not with parathyroid diseases.
Case reports of two patients describe the methods used.
We report two patients with hyperparathyroidism and congenital thyroid anomalies. One patient had a left thyroid lobe hemiagenesis and the other patient had agenesis of the thyroid isthmus. Both patients had primary hyperparathyroidism caused by parathyroid hyperplasia and were treated by subtotal parathyroidectomy. The parathyroid glands and recurrent laryngeal nerves were in their usual positions despite the abnormal development of the thyroid glands.
When thyroid hemiagenesis or isthmus agenesis is found in patients undergoing parathyroidectomy for hyperparathyroidism, parathyroid hyperplasia should be suspected. If parathyroid hyperplasia is present, subtotal parathyroidectomy and bilateral thymectomy are recommended. The parathyroid glands and the recurrent laryngeal nerves can be found in their usual locations.
先天性甲状腺异常可由甲状腺部分的异常下降或发育不全引起。甲状腺发育不全可能累及甲状腺的一叶或两叶，可伴有或不伴有峡部，且非常罕见。据报道，先天性甲状腺异常与甲状腺疾病（甲状腺功能亢进、腺瘤性甲状腺肿和癌症）有关，但与甲状旁腺疾病无关。
两名患者的病例报告描述了所采用的方法。
我们报告了两名患有甲状旁腺功能亢进和先天性甲状腺异常的患者。一名患者左侧甲状腺叶半缺如，另一名患者甲状腺峡部缺如。两名患者均因甲状旁腺增生导致原发性甲状旁腺功能亢进，并接受了甲状旁腺次全切除术治疗。尽管甲状腺发育异常，但甲状旁腺和喉返神经位置正常。
在因甲状旁腺功能亢进接受甲状旁腺切除术的患者中发现甲状腺半缺如或峡部缺如时，应怀疑甲状旁腺增生。如果存在甲状旁腺增生，建议进行甲状旁腺次全切除术和双侧胸腺切除术。甲状旁腺和喉返神经可在其正常位置找到。
