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甲状旁腺瘤所致的原发性甲状旁腺功能亢进在临床上并不罕见,不少患者全身骨显像具有全身骨胳显像剂浓聚显著增高,软组织本底极低,双肾不显影,即超级骨显像的表现,但前上纵隔异位甲状旁腺瘤功能亢进合并超级骨显像比较罕见,现报道如下。
前上纵隔异位甲状旁腺瘤功能亢进骨显像一例
Hyperfunction of an ectopic parathyroid adenoma in the anterior superior mediastinum: a case report of whole-body bone scintigraphy
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摘要: 笔者报道了一例前上纵隔异位甲状旁腺瘤功能亢进病例。58岁女性患者,有右侧髋部疼痛症状,MR检查考虑肿瘤多发骨转移。胸部CT检查发现前上纵隔软组织肿块影。99Tcm-MDP全身骨扫描呈超级骨显像。99Tcm-MIBI甲状旁腺显像考虑纵隔异位甲状旁腺瘤可能性大。经胸腔镜术后病理诊断为甲状旁腺瘤合并功能亢进。文献复习加深了对异位甲状旁腺瘤功能亢进合并超级骨显像的认识,前上纵隔异位甲状旁腺瘤功能亢进合并超级骨显像临床罕见,99Tcm-MDP全身骨显像结合99Tcm-MIBI甲状旁腺显像对疑诊的异位甲状旁腺瘤患者可以提供重要的辅助诊断信息。Abstract: The author reports a case of the hyperfunction of an ectopic parathyroidoma in the anterior superior mediastinum. A 58-year-old woman with pain in the right hip was diagnosed with multiple bone metastases through magnetic resonance imaging (MRI). Computed imaging revealed a soft tissue mass shadow in the anterior superior mediastinum of the patient's tomography (CT) chest. Super-bone imaging through whole-body bone scintigraphy and parathyroid scintigraphy indicated that the mass was an anectopic mediastinum parathyroidoma. Through pathological diagnosis after thoracoscopic surgery, the mass was identified as a parathyroid adenoma with hyperfunction. The ectopic parathyroid adenoma of the anterior superior mediastinum with hyperfunction and accompanied by changes in super-bone imaging is clinically rare. Technetium methylene diphosphonate (99Tcm-MDP) whole-body bone scintigraphy combined with technetium sestamibi (99Tcm-MIBI) parathyroid scintigraphy can provide important information for the diagnosis of suspected ectopic parathyroidoma.
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