Tertiary hyperparathyroidism accompanied with thyroid carcinoma and cervical lymph node sarcoidosis: a case report
-
-
关键词:
- 甲状腺肿瘤 /
- 结节病 /
- 继发性甲状旁腺功能亢进
Abstract: A 63-year-old female with 3 years of hemodialysis and 1 year of joint pain was treated with calcimimetics and other drugs for a long time. The bone and joint pain did not improve, and the serum PTH continued to rise. The left thyroid nodule was found during the preoperative localization examination of parathyroid gland. Preoperative examination showed that PTH 1258.9 ng/L, Ca 2.48 mmol/L, P 2.32 mmol/L, ALB 36.70 g/L, ALP 227.00 IU/L. Cervical ultrasonography showed thyroid nodules in the left lobe(TI-RADS 4b), parathyroid hyperplasia and enlargement, and abnormal lymph nodes in the Ⅲ region of the left neck. Postoperative pathology: ①Thyroid papillary carcinoma on the left side, the size of the tumor was about 0.7 cm; ②There were 3 lymph nodes in Ⅲ region, of which 1 showed metastasis, and 1 consistent with sarcoidosis; ③4 parathyroid glands showed proliferative lesions, including the formation of pseudotumor-like nodules on the left upper parathyroid gland with hyperparathyroidism and no cancer invasion; ④There were 6 lymph nodes in the central region, of which 3 showed metastasis; ⑤There was 1 prelaryngeal lymph node and showed metastasis; ⑥There were 8 lymph nodes in Ⅱ region, of which 1 showed metastasis; ⑦There were 21 lymph nodes in Ⅳ region, all of which had no metastasis.-
Key words:
- thyroid neoplasms /
- sarcoidosis /
- secondary hyperparathyroidism
-
-
[1] Jamal SA, Miller PD. Secondary and tertiary hyperparathyroidism[J]. J Clin Densitom, 2013, 16(1): 64-68. doi: 10.1016/j.jocd.2012.11.012
[2] 中国医师协会外科医师分会甲状腺外科医师委员会, 中国研究型医院学会甲状腺疾病专业委员会. 慢性肾功能衰竭继发甲状旁腺功能亢进外科临床实践专家共识[J]. 中国实用外科杂志, 2016, 36(5): 481-486. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWK201605004.htm
[3] Tominaga Y, Tanaka Y, Sato K, et al. Histopathology, pathophysiology, and indications for surgical treatment of renal hyperparathyroidism[J]. Semin Surg Oncol, 1997, 13(2): 78-86. doi: 10.1002/(SICI)1098-2388(199703/04)13:2<78::AID-SSU3>3.0.CO;2-Z
[4] Lin SY, Lin WM, Lin CL, et al. The relationship between secondary hyperparathyroidism and thyroid cancer in end stage renal disease: a population based cohort study[J]. Eur J Intern Med, 2014, 25(3): 276-280. doi: 10.1016/j.ejim.2014.01.001
[5] Miki H, Oshimo K, Inoue H, et al. Thyroid carcinoma in patients with secondary hyperparathyroidism[J]. J Surg Oncol, 1992, 49(3): 168-171. doi: 10.1002/jso.2930490308
[6] Ito Y, Miyauchi A, Jikuzono T, et al. Risk factors contributing to a poor prognosis of papillary thyroid carcinoma: validity of UICC/AJCC TNM classification and stage grouping[J]. World J Surg, 2007, 31(4): 838-848. doi: 10.1007/s00268-006-0455-0
[7] 孙姗姗, 卞雪艳, 郭文宇, 等. 甲状腺微小乳头状癌颈淋巴结转移的危险因素分析[J]. 中国肿瘤临床, 2015, 42(13): 658-662. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZL201513007.htm
[8] Isaacs JD, Lundgren CI, Sidhu SB, et al. The Delphian lymph node in thyroid cancer[J]. Ann Surg, 2008, 247(3): 477-482. doi: 10.1097/SLA.0b013e31815efdc4
[9] Askling J, Grunewald J, Eklund A, et al. Increased risk for cancer following sarcoidosis[J]. Am J Respir Crit Care Med, 1999, 160(5 Pt 1): 1668-1672.
[10] Blank N, Lorenz HM, Ho AD, et al. Sarcoidosis and the occurrence of malignant diseases[J]. Rheumatol Int, 2014, 34(10): 1433-1439. doi: 10.1007/s00296-014-2983-5
-
下载:
图(4)
计量
- 文章访问数: 1025
- PDF下载数: 261
- 施引文献: 0