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甲状旁腺癌(parathyroid carcinoma,PTC)是一类以甲状旁腺功能亢进为主要临床表现的十分罕见的恶性肿瘤。基于PTC肿瘤细胞的特点,大多数99Tcm-MIBI显像都会表现为阳性。但在某些特殊情况下,有极少部分PTC 99Tcm-MIBI显像表现为阴性,现报道如下。
99Tcm-MIBI双时相平面显像阴性的散发性甲状旁腺癌一例及文献复习
99Tcm-MIBI dual phase planar imaging negative in patient with sporadic parathyroid carcinoma: a case report and literature review
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摘要: 笔者报道了一例散发性甲状旁腺癌(PTC)99Tcm-甲氧基异丁基异腈(MIBI)显像阴性病例。PTC患者临床上表现为严重高钙血症引起的多个系统及器官的改变,需依赖于超声、甲状旁腺核素扫描(99Tcm-MIBI)、CT等检查明确定位后予以手术治疗,其中99Tcm-MIBI显像具有方法简便、灵敏度高的优势,被广泛应用于临床,但仍有少数病例存在检查结果阴性的可能,易造成患者误诊、漏诊。笔者通过文献复习加深了对99Tcm-MIBI显像阴性的PTC患者的认识:对于怀疑PTC,但99Tcm-MIBI显像阴性的患者,需考虑到可能存在假阴性,并应分析讨论导致假阴性可能的原因,进而结合其他临床特征进行综合判断,尽可能地减少患者的误诊及漏诊。Abstract: This paper reported a case of sporadic parathyroid carcinoma with negative 99Tcm-methoxyisobutylisonitrile (MIBI) imaging. The patient with parathyroid carcinoma is characterized by severe hypercalcemia which could cause pathological changes in multiple systems and different organs. It depends on ultrasound, parathyroid nuclide scan (99Tcm-MIBI) and CT examination to localize the position of lesions for further operation treatment. Among these examinations, parathyroid 99Tcm-MIBI imaging is widely used in clinical for its easy accessibility and high sensitivity. However, there are some cases presented with negative 99Tcm-MIBI imaging and is easy to be misdiagnosed. Through the literature review, the author deeply understood the negative 99Tcm-MIBI imaging of parathyroid carcinoma. For patients suspected of parathyroid carcinoma but with negative 99Tcm-MIBI imaging, the possibility of false negative need to be considered. In this specific clinical scenario, doctors should analyze its potential causes and make a comprehensive judgment through combining with other clinical characteristics, which could reduce the rate of misdiagnosis as much as possible.
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