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甲状旁腺癌的诊治:附6例报告
引用本文:陈润成,梁柳森,沈樑. 甲状旁腺癌的诊治:附6例报告[J]. 中国普通外科杂志, 2008, 17(5): 5-422
作者姓名:陈润成  梁柳森  沈樑
作者单位:广州医学院附属市一医院,普通外科,广东,广州,510180
摘    要:
目的 总结甲状旁腺癌(PTC)的诊治经验.方法 回顾分析6例PTC的临床资料.结果 5例有原发性甲状旁腺功能亢进症的表现,3例可扪及颈部肿块,4例高钙血症[(3.62±0.56 )mmol/L],4例血甲状旁腺素(PTH)升高达正常上限的2倍以上.3例术中快速病检确诊,2例术后石蜡病检及免疫组化确诊,1例术后石蜡病检及免疫组化结合临床资料确诊.5例行甲状旁腺切除术 患侧甲状腺次全切除术,随访1~5年,其中1例术后复发;1例仅行甲状旁腺肿瘤切除术的甲状旁腺癌伴多发性骨转称患者,术后16 d死于多器官功能衰竭.结论 PTC术前诊断困难,术前血生化检查,PTH,99mTc-MIBI,超声、CT检查及术中大体标本观察和快速病检有利于明确诊断.手术方式以选择甲状旁腺切除术 患侧甲状腺次全切除术为宜.

关 键 词:甲状旁腺肿瘤/外科学  甲状腺旁肿瘤/诊断  腺癌  甲状旁腺癌  诊治  carcinoma  parathyroid  treatment  Diagnosis  cases  选择  手术方式  明确诊断  快速  大体标本  生化检查  超声  术前诊断  多器官功能衰竭  患者  骨转  多发性  肿瘤切除术
文章编号:1005-6947(2008)05-0419-04
收稿时间:1900-01-01
修稿时间:2008-02-20

Diagnosis and treatment of parathyroid carcinoma:a report of 6 cases
CHEN Runcheng,LIANG Liusen,SHEN Liang . Diagnosis and treatment of parathyroid carcinoma:a report of 6 cases[J]. Chinese Journal of General Surgery, 2008, 17(5): 5-422
Authors:CHEN Runcheng  LIANG Liusen  SHEN Liang
Abstract:
Abstract:Objective:To summarize the experience for diagnosis and treatment of parathyroid carcinoma(PTC).
Methods :The clinical data of 6 patients with PTC were retrospectively analyzed.
Results:Five patients complained of primary hyperparathyroidism, 3 patients had manifestations of palpable neck mass, 4 patients were admitted for hypercalcemia with calcium level of (3.62±0.56 )mmol/L, and in 4 patients the parathyroid hormone(PTH) level was higher than two fold of the normal upper limit. Frozen section histopathology established diagnosis in 3 patients, routine histopathology combined with immunohistochemistry established the diagnosis in 2 patients, and routine histopathology combined with immunohistochemistry and clinical data established the diagnosis in 1 patient. Parathyroidectomy and ipsilateral subtotal thyroidectomy was performed in 5 patients, who were followed up for 1-5 years, recurrence in 1 patient 3 years after operation; tumor resection alone was performed in 1 patient with parathyroid cancer complicated with multiple bone metastasis, and the patient died of MOF 16 days postoperation.
Conclusions:The diagnosis of PTC is difficult before operation. Routine blood examinations, blood PTH , 99mTc-MIBI scintigraphy, ultrasonography, CT, observation of specimen, and frozen section histopathology during operation are helpful to diagnosis. The surgical procedure of choice is parathyroidectomy and ipsilateral subtotal thyroidectomy.
Keywords:Parathyroid Neoplasms/surg    Parathyroid Neoplasms /diag  Adenocarcinoma
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