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目的探讨甲状旁腺癌(parathyroid carcinoma,PTC)的诊断和治疗方法。方法回顾性分析8例PTC的临床资料。结果本组PTC占原发性甲状旁腺功能亢进症(primary hyperparathyroidism,PHPT)的5．7％,男女各4例,男性发病年龄较轻。其病程明显短于其他PHPT患者。6例以急性高血钙症状就诊,7例可扪及颈部肿块。患者血钙(3．75±0．34)mmol/L,甲状旁腺激素水平为(1429．47±841．75)pg／ml。仅1例术中冰冻明确诊断。4例接受甲状旁腺癌根治手术,随访10-58个月血钙正常。另4例接受肿瘤摘除术,其中3例在术后12-18个月复发。结论PTC急性高钙症状较多见,术中冰冻诊断价值有限。首次手术时根治切除是影响预后最重要的因素。
Objective To investigate the diagnosis and treatment of parathyroid carcinoma (PTC). Methods The clinical data of 8 cases of PTC were retrospectively analyzed. Results In this group, PTC accounted for 5.7% of primary hyperparathyroidism (PHPT), 4 males and 4 females, and the age of onset of men was lighter. The course of the disease is significantly shorter than other PHPT patients. Six cases were treated with acute hypercalcemia and 7 cases were palpable and neck lumps. The patient had serum calcium (3.75±0.34) mmol/L and parathyroid hormone levels (1429.47±841.75) pg/ml. Only one case of definite diagnosis of intraoperative frozen. Four patients underwent radical surgery for parathyroid carcinoma. Followed up for 10-58 months with normal serum calcium. The other 4 patients underwent tumor enucleation, of which 3 relapsed at 12-18 months postoperatively. Conclusions Symptoms of acute hypercalcemia in PTC are more common, and the value of intraoperative frozen diagnosis is limited. Radical resection during the first operation is the most important factor affecting prognosis.