大面部区域的多个棕色瘤是原发性副甲状腺炎症的初始表现
Mohd Aswad Khan1, Ahmad Alam2, Sajjad Abdur Rahman3
1Department of Burns, Plastic and Maxillofacial Surgery, VMMC and SJH, New Delhi, DL, India.
BMJ case reports
|December 19, 2025
概括
原发性副甲状腺功能障碍症 (PHPT) 可以导致中的罕见棕色瘤. 早期诊断和多学科的方法,包括副甲状腺切除术,导致瘤回归和荷尔蒙水平正常化.
科学领域:
- 内分泌学 在内分泌学.
- 口腔和牙面部外科手术
- 在瘤学瘤学.
背景情况:
- 原发性副甲状腺炎症 (PHPT) 是一种由过度的副甲状腺激素 (PTH) 分泌而形成的疾病.
- 棕色瘤是一种罕见的良性骨病变,可在PHPT患者中发生,原因是骨质细胞活性过高.
- 棕色瘤对大和下的影响是非常罕见的.
研究的目的:
- 报告一个罕见的发生在一个患有PHPT的患者身上广泛的上和下棕色瘤的病例.
- 要突出诊断挑战和成功管理这种罕见的呈现.
- 强调在患有无法解释的下巴胀和骨解病变的患者中考虑PHPT的重要性.
主要方法:
- 一个患者的病例报告,该患者有无痛的部胀和病理性骨折.
- 放射和生化评估,包括成像 (4D CT) 和激素水平评估 (iPTH).
- 切除组织的组织病理学检查和免疫组织化学 (H3G34W).
- 手术前的医疗管理 (denosumab) 和手术干预 (副甲状腺切除术).
主要成果:
- 该患者出现了严重的高血症,升高的IPTH,以及下巴和头骨中的多个骨解病变.
- 一个右下侧甲状腺腺瘤被确定并通过手术切除.
- 组织病理学证实了棕色瘤,H3G34W免疫组织化学是负的.
- 手术后,iPTH正常化,棕色瘤在6个月内出现回归.
结论:
- 胀和骨解损伤可能是PHPT的罕见表现.
- 涉及内分泌学,手术和病理学的多学科方法对于诊断和管理至关重要.
- 手术切除甲状腺腺瘤和医疗管理可以导致棕色瘤的解决和水平的正常化.
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