甲状腺内侧甲状腺癌伪装成囊性甲状腺结节:一个病例报告
Ko-Ping Tiang1, Kah Seng Khoo2, Nicholas Ken Yoong Hee3
1Department of Surgery, University of Malaya Medical Centre, Kuala Lumpur, Malaysia.
Gland surgery
|June 23, 2025
概括
副甲状腺癌 (PC) 是罕见的,经常在术后诊断出来. 这种病例显示PC呈现为囊性甲状腺结节,强调需要对囊性病变进行副甲状腺激素 (PTH) 测试.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 核医学是一种核医学.
背景情况:
- 副甲状腺癌 (PC) 是一种罕见的内分泌恶性瘤,发病率低.
- 甲状腺内PC非常罕见,这给诊断带来了挑战.
- 严重的高血症和偏甲状腺激素 (PTH) 水平升高是PC的关键指标.
研究的目的:
- 报告一种异常的甲状腺内甲状腺侧甲状腺癌病例,呈现为囊性甲状腺结节.
- 突出诊断局部化PC,特别是囊性病变的诊断挑战.
- 强调在囊性液中进行手术内附甲状腺激素 (IOPTH) 测定对诊断的有用性.
主要方法:
- 评估了一名患有原发性甲状腺功能障碍症和严重高血症的患者.
- 术前成像包括技术-99m-methoxyisobutylisonitrile (Tc-MIBI) 扫描和超声波.
- 监测了手术内副甲状腺激素 (IOPTH) 水平,并吸收了囊性液体进行PTH测定.
主要成果:
- 99m Tc-MIBI扫描局部化了左下部功能过高的副甲状腺,但切除并没有解决高血症.
- 超声波显示右甲状腺囊;吸收显示PTH水平显著升高 (1,060 pmol/L).
- 右甲状腺切除术证实了甲状腺内PC;术后PTH正常化,患者康复.
结论:
- 副甲状腺癌可以不典型地呈现为囊性甲状腺损伤.
- 在囊性部质量的差异诊断中考虑PC.
- 囊液PTH测定是一种潜在的有价值的诊断工具,用于甲状腺内PC.
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