Masson E A, MacFarlane I A, Bodmer C W, Vaughan E D
Department of Medicine, University of Liverpool.
Br J Oral Maxillofac Surg. 1993 Apr;31(2):117-9. doi: 10.1016/0266-4356(93)90174-u.
A 27-year-old man presented to his dentist with a swelling in his lower jaw. Histology revealed this to be a brown tumour associated with primary hyperparathyroidism and severe but asymptomatic hypercalcaemia. A large parathyroid adenoma was removed and the serum calcium fell to normal. Hypercalcaemia recurred and re-exploration of the neck revealed parathyroid metastases in cervical lymph nodes. A modified radical neck dissection was performed and he has remained normocalcaemic on Vitamin D analogues for 2 years. Bone disease of the mandible is a very rare presentation of primary hyperparathyroidism. The diagnosis of parathyroid malignancy is often difficult histologically, and the optimum treatment is uncertain.
一名27岁男性因下颌肿胀就诊于牙医处。组织学检查显示这是一个与原发性甲状旁腺功能亢进及严重但无症状的高钙血症相关的棕色瘤。切除了一个大的甲状旁腺腺瘤，血清钙降至正常。高钙血症复发，再次探查颈部发现颈部淋巴结有甲状旁腺转移。进行了改良根治性颈清扫术，他在使用维生素D类似物的情况下血钙正常已达2年。下颌骨的骨病是原发性甲状旁腺功能亢进非常罕见的表现。甲状旁腺恶性肿瘤的诊断在组织学上往往很困难，最佳治疗方法也不确定。
