PDF(Pubmed)
Abstract：
The most common cause of primary hyperparathyroidism (PHPT) is a solid parathyroid adenoma. Less than 2% of cases of PHPT are caused by cystic parathyroid adenomas formed from degeneration of pre-existing solid parathyroid adenomas. Cystic parathyroid adenomas are non-functional in over 90% of cases. In this case we describe management of a 56-year-old man with acute-onset polydipsia, polyuria, xerostomia, nausea, and constipation. Serum chemistry upon admission revealed hypercalcemia, hyperparathyroidism, and reduced serum phosphorus. Neck sonogram revealed a predominantly anechoic lesion later confirmed by pathology to be a cystic parathyroid adenoma in the right thyroid lobe. Sestamibi scan did not show uptake in parathyroid gland, and parathyroid hormone (PTH) was elevated in fine-needle aspiration sample. Otolaryngology removed the cystic lesion via surgical excision, which led to normalization of PTH level. This case demonstrates the importance of evaluation of cystic components for PTH levels and if confirmed should be treated as a parathyroid adenoma.
摘要：
原发性甲状旁腺功能亢进（PHPT）的最常见原因是实性甲状旁腺腺瘤。不到2％的PHPT病例是由先前存在的实性甲状旁腺腺瘤变性形成的囊性甲状旁腺腺瘤引起的。在超过90%的病例中,囊性甲状旁腺腺瘤是无功能的。在这种情况下，我们描述了一名56岁的急性多饮男子的管理，多尿,口干症,恶心,还有便秘.入院时血清化学显示高钙血症，甲状旁腺功能亢进,降低血清磷.颈部超声检查显示，主要是无回声病变，后来经病理证实为右甲状腺叶囊性甲状旁腺腺瘤。Sestamibi扫描未显示甲状旁腺摄取，细针抽吸样本中甲状旁腺激素（PTH）升高。耳鼻喉科通过手术切除了囊性病变，导致PTH水平正常化。此病例证明了评估PTH水平的囊性成分的重要性，如果得到证实，应作为甲状旁腺腺瘤治疗。
