Ca lâm sàng u cận giáp lạc chỗ kèm tăng sản một tuyến cận giáp
Nội dung chính của bài viết
Tóm tắt
Cường cận giáp nguyên phát là nguyên nhân phổ biến nhất gây tăng calci máu. Phẫu thuật tuyến cận giáp có thể điều trị khỏi trên 95% các trường hợp cường cận giáp nguyên phát. Các nguyên nhân gây cường cận giáp dai dẳng sau phẫu thuật là đa u tuyến cận giáp, tăng sản cả bốn tuyến cận giáp, bỏ sót tuyến cận giáp lạc chỗ. Chúng tôi báo cáo trường hợp bệnh nhân cường cận giáp dai dẳng sau phẫu thuật do u cận giáp lạc chỗ ở trung thất. Xét nghiệm PTH nhanh trong phẫu thuật giúp phát hiện sớm phẫu thuật thất bại và xạ hình tuyến cận giáp với sestamibi Tc 99m giúp xác định vị trí tuyến cận giáp bất thường lạc chỗ.
Chi tiết bài viết
Từ khóa
Tăng calci máu, cường cận giáp nguyên phát, u cận giáp lạc chỗ
Tài liệu tham khảo
1. Walker MD, Silverberg SJ. Primary hyperparathyroidism. Nat Rev Endocrinol. 2018;14(2):115-125. doi:10.1038/nrendo.2017.104
2. Roy M, Mazeh H, Chen H, Sippel RS. Incidence and Localization of Ectopic Parathyroid Adenomas in Previously Unexplored Patients. World J Surg. 2013;37(1):102-106. doi:10.1007/s00268-012-1773-z
3. Vijayakumar V, Anderson ME. Detection of ectopic parathyroid adenoma by early Tc-99m sestamibi imaging. Ann Nucl Med. 2005;19(2):157-159. doi:10.1007/BF03027396
4. Arora A. A PRACTICAL MANUAL OF Thyroid and Parathyroid Disease. :228.
5. Boggs JE, Irvin GL, Carneiro DM, Molinari AS. The evolution of parathyroidectomy failures. Surgery. 1999;126(6):998-1002; discussion 1002-1003.
6. Mazotas IG, Yen TWF, Doffek K, et al. Persistent/Recurrent Primary Hyperparathyroidism: Does the Number of Abnormal Glands Play a Role? J Surg Res. 2020;246:335-341. doi:10.1016/j.jss.2019.08.007
7. Alhefdhi A, Schneider DF, Sippel R, Chen H. Recurrent and persistence primary hyperparathyroidism occurs more frequently in patients with double adenomas. J Surg Res. 2014;190(1):198-202. doi:10.1016/j.jss.2014.02.024
8. Gouveia S, Rodrigues D, Barros L, et al. Persistent primary hyperparathyroidism: an uncommon location for an ectopic gland - Case report and review. Arq Bras Endocrinol Metabol. 2012;56:393-403. doi:10.1590/S0004-27302012000600009
9. Gough I. Reoperative Parathyroid Surgery: The Importance of Ectopic Location and Multigland Disease. ANZ J Surg. 2006;76(12):1048-1050. doi:10.1111/j.1445-2197.2006.03931.x
10. Cheung K, Wang TS, Farrokhyar F, Roman SA, Sosa JA. A meta-analysis of preoperative localization techniques for patients with primary hyperparathyroidism. Ann Surg Oncol. 2012;19(2):577-583. doi:10.1245/s10434-011-1870-5
11. Ruda JM, Hollenbeak CS, Stack BC. A systematic review of the diagnosis and treatment of primary hyperparathyroidism from 1995 to 2003. Otolaryngol--Head Neck Surg Off J Am Acad Otolaryngol-Head Neck Surg. 2005;132(3):359-372. doi:10.1016/j.otohns.2004.10.005
12. Kluijfhout WP, Venkatesh S, Beninato T, et al. Performance of magnetic resonance imaging in the evaluation of first-time and reoperative primary hyperparathyroidism. Surgery. 2016;160(3):747-754. doi:10.1016/j.surg.2016.05.003
13. Kunstman JW, Kirsch JD, Mahajan A, Udelsman R. Parathyroid Localization and Implications for Clinical Management. J Clin Endocrinol Metab. 2013;98(3):902-912. doi:10.1210/jc.2012-3168
14. Kluijfhout WP, Pasternak JD, Beninato T, et al. Diagnostic performance of computed tomography for parathyroid adenoma localization; a systematic review and meta-analysis. Eur J Radiol. 2017;88:117-128. doi:10.1016/j.ejrad.2017.01.004
15. Smith JR, Oates ME. Radionuclide Imaging of the Parathyroid Glands: Patterns, Pearls, and Pitfalls. RadioGraphics. 2004;24(4):1101-1115. doi:10.1148/rg.244035718
16. Yamada T, Ikuno M, Shinjo Y, et al. Selective venous sampling for primary hyperparathyroidism: how to perform an examination and interpret the results with reference to thyroid vein anatomy. Jpn J Radiol. 2017;35(8):409-416. doi:10.1007/s11604-017-0658-3
17. Calò PG, Pisano G, Loi G, et al. Intraoperative parathyroid hormone assay during focused parathyroidectomy: the importance of 20 minutes measurement. BMC Surg. 2013;13(1):36. doi:10.1186/1471-2482-13-36
2. Roy M, Mazeh H, Chen H, Sippel RS. Incidence and Localization of Ectopic Parathyroid Adenomas in Previously Unexplored Patients. World J Surg. 2013;37(1):102-106. doi:10.1007/s00268-012-1773-z
3. Vijayakumar V, Anderson ME. Detection of ectopic parathyroid adenoma by early Tc-99m sestamibi imaging. Ann Nucl Med. 2005;19(2):157-159. doi:10.1007/BF03027396
4. Arora A. A PRACTICAL MANUAL OF Thyroid and Parathyroid Disease. :228.
5. Boggs JE, Irvin GL, Carneiro DM, Molinari AS. The evolution of parathyroidectomy failures. Surgery. 1999;126(6):998-1002; discussion 1002-1003.
6. Mazotas IG, Yen TWF, Doffek K, et al. Persistent/Recurrent Primary Hyperparathyroidism: Does the Number of Abnormal Glands Play a Role? J Surg Res. 2020;246:335-341. doi:10.1016/j.jss.2019.08.007
7. Alhefdhi A, Schneider DF, Sippel R, Chen H. Recurrent and persistence primary hyperparathyroidism occurs more frequently in patients with double adenomas. J Surg Res. 2014;190(1):198-202. doi:10.1016/j.jss.2014.02.024
8. Gouveia S, Rodrigues D, Barros L, et al. Persistent primary hyperparathyroidism: an uncommon location for an ectopic gland - Case report and review. Arq Bras Endocrinol Metabol. 2012;56:393-403. doi:10.1590/S0004-27302012000600009
9. Gough I. Reoperative Parathyroid Surgery: The Importance of Ectopic Location and Multigland Disease. ANZ J Surg. 2006;76(12):1048-1050. doi:10.1111/j.1445-2197.2006.03931.x
10. Cheung K, Wang TS, Farrokhyar F, Roman SA, Sosa JA. A meta-analysis of preoperative localization techniques for patients with primary hyperparathyroidism. Ann Surg Oncol. 2012;19(2):577-583. doi:10.1245/s10434-011-1870-5
11. Ruda JM, Hollenbeak CS, Stack BC. A systematic review of the diagnosis and treatment of primary hyperparathyroidism from 1995 to 2003. Otolaryngol--Head Neck Surg Off J Am Acad Otolaryngol-Head Neck Surg. 2005;132(3):359-372. doi:10.1016/j.otohns.2004.10.005
12. Kluijfhout WP, Venkatesh S, Beninato T, et al. Performance of magnetic resonance imaging in the evaluation of first-time and reoperative primary hyperparathyroidism. Surgery. 2016;160(3):747-754. doi:10.1016/j.surg.2016.05.003
13. Kunstman JW, Kirsch JD, Mahajan A, Udelsman R. Parathyroid Localization and Implications for Clinical Management. J Clin Endocrinol Metab. 2013;98(3):902-912. doi:10.1210/jc.2012-3168
14. Kluijfhout WP, Pasternak JD, Beninato T, et al. Diagnostic performance of computed tomography for parathyroid adenoma localization; a systematic review and meta-analysis. Eur J Radiol. 2017;88:117-128. doi:10.1016/j.ejrad.2017.01.004
15. Smith JR, Oates ME. Radionuclide Imaging of the Parathyroid Glands: Patterns, Pearls, and Pitfalls. RadioGraphics. 2004;24(4):1101-1115. doi:10.1148/rg.244035718
16. Yamada T, Ikuno M, Shinjo Y, et al. Selective venous sampling for primary hyperparathyroidism: how to perform an examination and interpret the results with reference to thyroid vein anatomy. Jpn J Radiol. 2017;35(8):409-416. doi:10.1007/s11604-017-0658-3
17. Calò PG, Pisano G, Loi G, et al. Intraoperative parathyroid hormone assay during focused parathyroidectomy: the importance of 20 minutes measurement. BMC Surg. 2013;13(1):36. doi:10.1186/1471-2482-13-36