甲状旁腺腺瘤手术切除后成功康复--病例报告

Malinga Gunarathne, Udayakumara Edippuliarachchige, Priyantha Madhuranga, Prabath Madhuwantha, Sashika Chathuranga, Saman Jayasinghe, Tharaka Dissanayaka, Janith Eeshwara, Parakrama Karunathilaka
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摘要

甲状旁腺腺瘤是一种甲状旁腺增生性疾病,患者通常伴有原发性甲状旁腺功能亢进的证据,诊断具有挑战性,尤其是在斯里兰卡这种资源匮乏的环境中,需要采用多种影像学方法。我们报告了一例52岁女性患者的病例,她因长期背痛5年多未缓解,伴有进行性双侧髋关节和肩关节疼痛,全身酸痛,长期乏力,被发现患有高钙血症,后被诊断为原发性甲状旁腺功能亢进症和甲状旁腺腺瘤伴多结节性甲状腺肿。在切除甲状旁腺腺瘤和保留其他甲状旁腺的甲状腺全切除术后,她的临床症状得到了极大改善。本病例的结论是,当患者出现模糊症状和高钙血症症状时,临床上需要高度怀疑甲状旁腺腺瘤的诊断,并应根据情况采用多种影像学检查方法进行早期诊断,以防止潜在并发症的发生。通过手术切除甲状旁腺腺瘤,保留正常腺体,预后良好,可在数月内完全缓解症状。
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Parathyroid Adenoma with Successful Recovery Following Surgical Resection—Case Report

Parathyroid adenoma is a parathyroid proliferative disorder where the patients typically present with evidence of primary hyperparathyroidism where the diagnosis is challenging especially in a resource-poor setting like Sri Lanka and requires multiple imaging modalities. We present a case of a 52-year female who presented with non-resolving long-standing back pain for more than 5 years, associated with progressive bilateral hip joint and shoulder joint pain with generalized body aches with prolonged fatigue who was found to have hypercalcemia and later diagnosed with primary hyperparathyroidism and parathyroid adenoma with multinodular goiter. She had a tremendous clinical improvement following the resection of the parathyroid adenoma along with a total thyroidectomy preserving other parathyroid glands. This case concludes that parathyroid adenoma diagnosis requires high clinical suspicion when patients present with vague symptoms and hypercalcaemic symptoms and should proceed with a workup with multiple imaging modalities depending on the availability for early diagnosis to prevent potential complications. Surgical resection of parathyroid adenoma preserving normal gland results in a good prognosis with complete symptomatic relief within a few months.

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