Andersson A, Bergdahl L
Am J Surg. 1977 Mar;133(3):333-7. doi: 10.1016/0002-9610(77)90541-4.
Acute hyperparathyroidism should be distinguished from severe hypercalcemia of malignancy. In the former condition parathyroidectomy is often of vital importance; in the latter, the malignant neoplasm should be treated surgically or with radiation or cytostatics. The differential diagnosis is sometimes difficult because some patients with acute hyperparathyroidism have coexisting carcinoma elsewhere. Two patients subjected to parathyroidectomy because of severe hypercalcemia secondary to malignant neoplasms are described and compared with twelve similar cases from the literature. In patients with severe hypercalcemia medical treatment should always be tried first. If acute hyperparathyroidism cannot be excluded, subtotal parathyroidectomy should be performed after medical preparation.
急性甲状旁腺功能亢进应与恶性肿瘤所致的严重高钙血症相鉴别。在前一种情况下，甲状旁腺切除术往往至关重要；而在后一种情况下，恶性肿瘤应通过手术、放疗或细胞抑制剂进行治疗。鉴别诊断有时很困难，因为一些急性甲状旁腺功能亢进患者同时患有其他部位的癌症。本文描述了两名因恶性肿瘤继发严重高钙血症而接受甲状旁腺切除术的患者，并与文献中的12例类似病例进行了比较。对于严重高钙血症患者，应始终首先尝试药物治疗。如果不能排除急性甲状旁腺功能亢进，应在药物准备后进行甲状旁腺次全切除术。
