基础医学与临床 ›› 2013, Vol. 33 ›› Issue (11): 1489-1492.

• 临床园地 • 上一篇    下一篇

原发甲状旁腺功能亢进症合并甲状腺乳头状癌的诊治

周颋1,李伟2,王鸥3,邢小平4,5,连小兰1   

  1. 1. 北京协和医院
    2. 中国医学科学院北京协和医学院 北京协和医院
    3. 中国医学科学院北京协和医学院北京协和医院内分泌科
    4. 中国医学科学院 北京协和医学院 北京协和医院
    5.
  • 收稿日期:2013-07-08 修回日期:2013-09-17 出版日期:2013-11-05 发布日期:2013-10-28
  • 通讯作者: 连小兰 E-mail:lianlanx@126.com

The diagnosis and treatment of primary hyperparathyroidism in association with papillary thyroid carcinoma

  • Received:2013-07-08 Revised:2013-09-17 Online:2013-11-05 Published:2013-10-28

摘要: 目的 探讨原发甲旁亢合并甲状腺乳头状癌的诊断、治疗,减少误诊及漏诊。方法 回顾分析北京协和医院1983年至2011年诊治的3例原发甲旁亢同时合并甲状腺乳头状癌患者的病史、实验室检查、影像资料、手术及病理,结合文献加以分析总结。结果 患者2女1男,年龄37∽59岁,入院时血钙2.78∽3.1mmol/L,PTH 202∽241pg/mL,甲状旁腺B超提示2例可见增大的甲状旁腺,1例正常,MIBI显像均为阳性。甲状腺方面:甲状腺B超2例提示甲状腺有结节,1例未发现。3例都首先进行了甲状旁腺手术,2例为增生,1例为腺瘤。2例在行甲旁亢手术同时行了甲状腺结节和甲状腺的部分切除术,术后病理为甲状腺乳头状癌,遂进行第2次甲状腺手术。第3例在甲旁亢手术同时行了甲状腺全切+中央淋巴结清扫。结论 原发甲旁亢合并甲状腺乳头状癌临床上比较少见,术前对甲状腺结节评估和术中甲状腺的探查都很重要。

关键词: 原发甲状腺旁腺功能亢进症1, 甲状腺乳头状癌2, 诊断3, 治疗4

Abstract: Objective To describe a rare manifestation of primary hyperparathyroidism in association with papillary thyroid carcinoma and to decrease misdiagnosis and missed diagnosis.Methods We describe the clinical history, findings on physical examination, results of laboratory studies,imaging findings, and histopathologic features of three patients who were diagnosed hyperparathyroidism and papillary thyroid carcinoma in PUMCH from 1983∽2011.Results There are two women and a men,from 37 to 59 years old.They were presented to our clinic because of primary hyperparathyroidism .Serum Ca 2.78∽3.1 mmol/L,PTH 202∽241pg/mL,MIBI(+).Ultrasonography revealed solitary nodule in two people,another is no.At first, Parathyroidectomy was performed in three of them .Then ,Total thyroidectomy was performed,two of them were proposed in two step. Conclusion The concurrence of primary hyperparathyroidism and papillary thyroid carcinoma are rare. Intraoperative evaluation of the thyroid is as important as preoperative evaluation with ultrasonography in patients with thyroid and parathyroid.

Key words: primary hyperparathyroidism 1, papillary thyroid carcinoma 2, diagnosis 3, treatment 4