中国实用外科杂志

中国实用外科杂志

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甲状旁腺癌的诊断和治疗（附30例报告）

陈海珍，薛    松，陈    曦，沈晓卉，姜    敏，丁家增，李宏为   

  1. 上海交通大学医学院附属瑞金医院普外科，上海200025
  • 出版日期:2014-04-01 发布日期:2014-03-31

  • Online:2014-04-01 Published:2014-03-31

摘要：

目的    探讨甲状旁腺癌（parathyroid carcinoma，PC）的诊断与治疗。方法    回顾性分析上海交通大学医学院附属瑞金医院2000年1月至2013年12月30例PC病人的临床资料。结果    男性10例，女性20例，占同期收治原发性甲状旁腺功能亢进（primary hyperparathyroidism，PHPT）病人的8.2%。30例病人均经手术治疗，8例术后1～11年复发，不同的初次术式预后差距较大。结论    PC术前、术中诊断应结合临床表现、影像资料、实验室资料、术中探查等综合分析。诊断为PC的病人基本术式应为病变甲状旁腺切除+同侧甲状腺全切除。对于首次手术单纯切除病变旁腺或连带部分同侧甲状腺切除而后石蜡确诊PC的病人，应在初次术后2～3周内尽快行二次补充手术。

关键词: 甲状旁腺癌, 原发性甲状旁腺功能亢进, 甲状腺

Abstract:

Diagnosis and treatment of parathyroid carcinoma：A report of 30 cases        CHEN Hai-zhen, XUE Song, CHEN Xi, et al. Department of General Surgery, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine，Shanghai200025, China
Corresponding auther: CHEN Xi, E-mail: chz11011@rjh.com.cn
Abstract    Objective    To evaluate the diagnosis and surgical treatment of parathyroid carcinoma (PC). Methods    The clinical data of 30 cases of PC admitted from January 2000 to December 2013 in Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine were analyzed retrospectively. Results    There were 10 men and 20 women, which accounted for 8.22% of cases of primary hyperparathyroidism (PHPT)．Thirty cases were all treated by operation and 8 cases developed recurrence in 1—11 years postoperatively. The initial operation was closely related with the prognosis. Conclusion    The preoperative and intraoperative diagnosis of PC should be combined with clinical manifestations, imaging data, laboratory data and intraoperative exploration, etc. PC cases should be performed pathological parathyroid resection plus homolateral total thyroid resection. For PC cases performed pathological parathyroid resection or plus homolateral partial thyroid resection in the initial operation, supplementary operation should be taken in 2—3 weeks after initial operation.

Key words: parathyroid carcinoma, primary hyperparathyroidism, thyroid