无功能性甲状旁腺囊肿的外科诊治

Diagnosis and surgical treatment of nonfunctional parathyroid cyst

目的：探讨无功能性甲状旁腺囊肿的临床特征、诊断及治疗方法,提高对无功能性甲状旁腺囊肿的诊治水平. 方法：回顾性分析1995年4月至2014年8月期间我院收治的无功能性甲状旁腺囊肿8例病人的临床资料.结果：共有8例病人,中位年龄56（26～73）岁.肿瘤平均直径（3.4±0.4）（2.1～5.6） cm.术前甲状腺功能、血清钙检测均在正常范围.术前B超检查8例病人均提示囊性占位.术中行冷冻检查,7例提示囊肿为甲状旁腺来源.所有8例术后病理均证实为甲状旁腺囊肿.所有病例均完整切除囊肿.其中1例伴有结节性甲状腺肿行甲状腺大部切除术,1例因同时伴有甲状腺乳头状癌,行根治性切除手术.术后1例病人出现声音嘶哑,在术后3个月时恢复正常.中位随访时间8.4年,随访期间无囊肿复发. 结论：术前超声和CT检查可初步诊断无功能性甲状旁腺囊肿,确诊需待病理检查. 完整的囊肿切除是无功能性甲状旁腺囊肿的有效治疗方法.

Objective To investigate the clinical characteristics, diagnosis and surgical treatment of nonfunctional parathyroid cyst. Methods The clinical data of patients with nonfunctional parathyroid cyst in our hospital from April 1995 to August 2014 were retrospectively analyzed. Results There were 8 patients with the median age 56 （26-73） years. The mean diameter of tumor was （3.4±0.4） （2.1-5.6） cm. The levels of serum thyroxine and calcium were all normal. Cystic le-sions were detected by ultrasonography prior to surgery. Seven patients underwent intraoperative frozen section examination and were diagnosed parathyroid cyst while all were diagnosed parathyroid cyst by pathologic examination postoperatively. One patient received subtotal thyroidectomy for nodular goiter and one had radical resection for papillary carcinoma. One patient had postoperative hoarseness recovered 3 months later. No recurrence was observed after a median follow-up of 8.4 years. Conclusions Preoperative ultrasonography and CT scan could make an initial diagnosis of nonfunctioning parathy-roid cysts. Pathological examination is needed for diagnosis. Complete resection of the cyst is the only effective treatment of nonfunctional parathyroid cyst.