Abstract：
<b><br>Introduction:</b> Primary hyperparathyroidism (PHPT) is mainly caused by parathyroid adenoma (PA). Rare variants of PA, weighing >2.0-3.5 g are called \"large\" or \"giant\" adenomas and account for about 1.5% of all PA.</br> <b><br>Aim:</b> The aim of this study was to compare normal-sized and large parathyroid lesions identifying risk factors for severe hypercalcemia.</br> <b><br>Materials and methods:</b> 27 patients with PHPT and parathyroid lesion ≥2.0 cm3 (study group) were compared with 73 patients with PHPT and lesion < 2.0 cm<sup>3</sup> (control group). In both groups, the majority were women (81.5% - study group, 90.5% - control group, gender ratios 4.4:9.1, respectively). The patients were examined preoperatively and postoperatively: PTH, creatine, calcium, and phosphate serum and urine concentrations, and calcidiol serum levels were assessed. Preoperative ultrasonography (US) was performed.</br> <b><br>Results:</b> Patients with larger parathyroid lesions had signifficantly higher PTH and calcium serum concentrations and lower serum phosphate and calcidiol concentrations. There were no statistically significant differences in the concentration of creatine in serum and urine, calciuria, or tubular reabsorption of phosphorus (TRP). US relatively underestimated the parathyroid volume by about 0.3-0.4 mL (10% in larger lesions and 43% in smaller ones).</br> <b><br>Conclusions:</b> Due to higher PTH and calcium levels, larger parathyroid adenomas may constitute a higher risk of severe hypercalcemia. In general, US underestimated the parathyroid volume.</br>.
摘要：
<b>br>简介:</b>原发性甲状旁腺功能亢进(PHPT)主要由甲状旁腺腺瘤(PA)引起。PA的罕见变体，体重2.0-3.5g被称为“大”或“巨大”腺瘤，约占所有PA的1.5%。</br><b>br>目的：</b>这项研究的目的是比较正常大小和大的甲状旁腺病变，以确定严重高钙血症的危险因素。</br><b>br>材料与方法:</b>27例PHPT和甲状旁腺病变≥2.0cm3患者(研究组)与73例PHPT和病变<2.0cm<sup>3</sup>患者(对照组)进行比较。在这两组中,大多数是女性(81.5%-研究组，90.5%——对照组，性别比例分别为4.4:9.1)。患者术前和术后进行检查：PTH，肌酸,钙，以及磷酸盐血清和尿液浓度，和骨化二醇血清水平进行评估。进行术前超声检查（US）。</br><b>br>结果：</b>甲状旁腺病变较大的患者血清PTH和钙浓度明显较高，血清磷酸盐和骨化二醇浓度较低。血清和尿液中的肌酸浓度无统计学差异，钙尿症,或管状磷再吸收（TRP）。美国相对低估了甲状旁腺体积约0.3-0.4mL（较大病变为10％，较小病变为43％）。</br><b><br>结论：</b>由于PTH和钙水平较高,较大的甲状旁腺腺瘤可能构成严重高钙血症的较高风险.总的来说,美国低估了甲状旁腺的体积。</br>.
