機能性上皮小体嚢腫の2例

Abstract

症例1, 48歳男, 近医で右頸部の腫脹を甲状腺嚢腫と診断され, 嚢腫穿刺を施行された.その後高カルシウム血症クリーゼ出現し, 当院内科に入院した.症例2, 69歳女, 右頸部の違和感を自覚し, 健診で右頸部の腫瘤を指摘され, 入院となった.両例とも血中カルシウム濃度, 上皮小体ホルモン(PTH)値は上昇していた.US, CT, MRI, シンチグラフィーを含む画像所見より機能性上皮小体嚢腫と診断し, 手術を施行した.上皮小体切除後, 血中カルシウムとPTH値は正常に復したが, カルシウム補充が症例1では必要であった

Two cases of functioning cysts are reported. The first patient was a 48-year-old man who underwent percutaneous cyst puncture for a palpable mass in the neck at another hospital. Hypercalcemic crisis brought the patient to Koga General Hospital. The second patient was a 69-year-old woman with the complaint of discomfort in the right neck of several years duration and with a palpable mass identified on physical examination at a local hospital. Both patients had high serum calcium and parathyroid hormone (PTH) levels and were diagnosed as having functioning parathyroid cysts by imaging studies including ultrasonography, computed tomographic scan, magnetic resonance imaging and scintigraphy. After parathyroidectomy, their serum calcium and PTH levels became normal, but calcium supplement was necessary in the first patient. To our knowledge, these are the 40th and 41st cases reported in the Japanese literature.