不典型甲状旁腺腺瘤:1例报告

Atypical parathyroid adenoma: A case report

目的:本文介绍1例不典型甲状旁腺腺瘤(atypical parathyroid adenoma,APA)患者的诊治经过,旨在提高临床医师对APA的认识。方法:报道1例APA患者的诊治经过,并结合相关文献进行分析。结果:1例37岁女性患者以腰部及右骶髂关节隐痛起病,18氟-氟代脱氧葡萄糖-正电子发射计算机断层成像(uorine-18-uorodeoxy glucosepositron emission tomography,18F-FDG-PET)-CT和细针穿刺细胞学检查诊断为甲状腺神经内分泌癌;接受甲状腺全切术后,病理诊断为APA。给予补钙和唑来膦酸治疗。随访半年,无复发征象,预后良好。结论:APA是一种较为罕见的疾病,是介于甲状旁腺腺瘤与甲状旁腺癌之间的一种状态,被认为是恶性潜能未定的肿瘤。对此类患者,应进行密切随访,监测术后复发情况,以及是否恶变为甲状旁腺癌。

Objective： This paper describes the diagnosis and treatment of a patient with atypical parathyroid adenoma （APA）, and aims to improve the understanding of APA in clinicians. Methods： The diagnosis and treatment of a patient with APA were reported, and the related literatures were reviewed. Results： A 37-year old female patient complained of waist and right sacroiliac joint pain. The diagnosis of thyroid neuroendocrine carcinoma was suggested based on fluorine-18-fluorodeoxy glucose- positron emission tomography-CT （18F-FDG-PET-CT） and fine needle aspiration cytology; after thyroidectomy, the final diagnosis was APA based on the pathological result. Calcium supplementation and zoledronic acid were given. The follow-up was half a year, and there was no recurrence, and the prognosis was good.Conclusion： APA is a rare disease and is a state between parathyroid adenoma and parathyroid carcinoma. It is considered to have an unknown malignant potential. For such patients, close follow-up should be carried out to monitor the recurrence after the surgery and whether or not it will transform to parathyroid carcinoma.