■遗传性原发性甲状旁腺功能亢进(PHPT)占所有PHPT病例的5-10%,诊断和管理需要基因检测。其中,甲状旁腺功能亢进-颌骨肿瘤综合征(HPT-JT)是由CDC73突变引起的常染色体显性疾病,临床表现多样,症状不完整.
■先证者,诊断为PHPT,41岁时接受甲状旁腺切除术,病理检查为甲状旁腺癌(PC)。由于早发性PHPT和家族史,最初怀疑遗传性PHPT。基因检测发现了一个杂合的CDC73突变,NM_024529.4:c。687_688delAG(p。Arg229Serfs*37).即使没有颌骨肿瘤,根据肾囊肿的发现证实了HPT-JT的诊断。进行了二次甲状腺切除术以降低复发风险。
■对于早发性PHPT,强烈建议进行基因检测,家族史,颌骨肿瘤,肾和子宫受累,非典型甲状旁腺肿瘤,和PC。此测试为个性化管理提供了有价值的信息,受影响的家庭可以获得咨询。
Hereditary primary hyperparathyroidism (PHPT) accounts for 5-10% of all PHPT cases, necessitating genetic testing for diagnosis and management. Among these, hyperparathyroidism-jaw tumor syndrome (HPT-JT) is an autosomal dominant disorder caused by CDC73 mutations with variable clinical presentations and incomplete symptoms.
The proband, diagnosed with PHPT, underwent parathyroidectomy at the age of 41 with pathological examination of parathyroid carcinoma (PC). Hereditary PHPT was initially suspected due to the early-onset PHPT and family history. Genetic testing identified a heterozygous CDC73 mutation, NM_024529.4: c. 687_688delAG (p. Arg229Serfs*37). Even in the absence of jaw tumors, the diagnosis of HPT-JT was confirmed based on the discovery of renal cysts. A secondary thyroidectomy was performed to reduce the risk of recurrence.
Genetic testing is strongly recommended in cases of early-onset PHPT, family history, jaw tumors, renal and uterine involvement, atypical parathyroid tumors, and PC. This testing provides valuable information for personalized management, and counseling is available for affected families.