Clinical features and diagnosis of parathyroid adenoma with cystic degeneration：A report of 8 cases        ZHAO Hai-ying, CUI Yong, ZHOU Yong, et al. Department of General Surgery, Affiliated Shengjing Hospital, China Medical University，Shenyang 110004, China
Corresponding author：LIU Jin-gang, E-mail：liujg@sj-hospital.org
Abstract    Objective    To evaluate the clinical features and diagnosis of parathyroid adenoma with cystic degeneration. Methods    The clinical data of 8 cases of parathyroid adenoma with cystic degeneration and 50 cases of parathyroid adenoma without cystic degeneration performed surgery and identified by pathology between January 2003 and August 2012 in Department of General Surgery, Affiliated Shengjing Hospital of China Medical University were analyzed retrospectively. The serum calcium, serum parathyroid hormone (PTH), parathyroid crisis, lesion size and diagnosis methods between cystic degeneration group and no cystic degeneration group were compared and analyzed. Results There was no difference in serum calcium, serum PTH and incidence of parathyroid crisis between two groups. The mean largest diameter of lesion in cystic degeneration group was （37.1±13.8）mm, in no cystic degeneration group it was （23.6±11.4）mm, there was statistical difference between two groups (P＜0.01). In all parathyroid adenomas, the sensitivity, accuracy, positive predictive value in ultrasonography, CT and MIBI scintigraphy was 82.1%, 79.3%, 95.8%; 66.7%, 66.7%, 100.0%; 71.4%, 68.2% and 93.8% respectively. There was no statistical difference among the three groups. The sensitivity of ultrasonography in cystic degeneration group was 37.5%, lower than it in no cystic degeneration group (89.6%), there was statistical difference between two groups (P＜0.01). Conclusion    In both parathyroid adenoma with cystic degeneration group and no cystic degeneration group, the clinical feature is the same. There is no difference in serum calcium and serum PTH, and cystic degeneration does not increase the incidence of parathyroid crisis, while size is larger in cystic degeneration group. When cystic degeneration happened, the misdiagnosis increases, it should use both ultrasonography and MIBI scintigraphy for the diagnosis.