甲状旁腺癌的早期识别和处理

Early identification and treatment of parathyroid carcinoma

甲状旁腺癌是一种罕见的内分泌肿瘤.临床表现多样,主要是高钙血症引起的全身多个器官受累.迄今为止,本病的病因及发病机制尚不明确,术前诊断较为困难,核素显像及超声可帮助发现早期病灶.手术全切及可疑受累淋巴结切除是唯一有效的治疗方法,化疗及放疗效果欠佳,新型免疫治疗的疗效亦不确切.本病的治疗效果及预后主要取决于初次手术时肿瘤的完全切除,超过50％的患者会出现复发,预后较差.

Parathyroid carcinoma is a rare endocrine tumor.Clinical manifestations are varied with multiple organs involved,mainly due to hypercalcemia.So far the etiology and pathogenesis of parathyroid carcinoma are still unclear and preoperatively diagnosis is difficult.Technetium-99 m sestamibi scan and ultrasound can help to find the early lesions.Complete surgical resection with suspicious involved lymph nodes is the recommended treatment.Parathyroid carcinoma is insensitive to chemotherapy and radiotherapy.New immune therapy yields unsure efficacy.Therapeutic effect and prognosis mainly depend on primary surgical resection of the tumor.The disease recurs in more than 50％ of patients with poor prognosis.