超声引导下无水乙醇硬化结合微波消融治疗功能性甲状旁腺囊肿1例

Ultrasound-guided anhydrous ethanol and microwave ablation for functional parathyroid cyst:a case report

目的报告超声引导下无水乙醇硬化+微波消融治疗功能性甲状旁腺囊肿患者1例,结合文献讨论该病的临床表现、定性定位诊断及治疗手段。方法患者高钙血症、高PTH、颈部囊性占位性病变,通过超声、核素扫描及抽吸囊液测PTH浓度诊断为功能性甲状旁腺囊肿,因拒绝行囊肿切除手术,故在超声引导下行无水乙醇硬化+微波消融治疗。结果术程顺利,术中术后无并发症发生。随访18个月,肿物明显缩小,血钙、血iPTH维持正常,达到临床治愈标准。结论国内外尚无消融治疗功能性甲状旁腺囊肿的报道,此方法可能为无法手术的功能性甲状旁腺囊肿患者提供微创治疗选择。然而,此项技术的疗效和安全性还需更多病例、更长随访时间来评估。

We report a case of functional parathyroid cyst treated by ultrasound-guided anhydrous ethanol sclerotherapy and microwave ablation.The 63-year-old female patient was diagnosed to have functional parathyroid cyst with hypercalcemia,high PTH and cystic space-occupying lesions in the neck by ultrasound,radionuclide scanning and PTH measurement of the cystic fluid.The patient refused to receive cyst resection,and anhydrous ethanol sclerotherapy with microwave ablation was performed under ultrasound guidance.The procedure was completed smoothly without any complications either during or after the operation.Follow-up examination of the patient at 18 months after the operation showed a significant reduction of the mass and normal blood calcium and iPTH levels,demonstrating a clinical cure of the patient.Ablative treatment of functional parathyroid cyst has not been documented so far.This approach provides a minimally invasive treatment modality for such cases where surgical resection is not an option,but its efficacy and safety need to be evaluated in more cases with longer follow-up time.