Cường cận giáp nguyên phát có tăng canxi máu nặng do u tuyến cận giáp lạc chỗ trung thất trước: Trường hợp lâm sàng
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Keywords
Cường cận giáp nguyên phát, u tuyến cận giáp lạc chỗ
Tóm tắt
Cường cận giáp nguyên phát là một rối loạn nội tiết tương đối phổ biến, nguyên nhân gây bệnh chủ yếu là do u tuyến cận giáp. Tuy nhiên, một số u tuyến cận giáp lạc chỗ đôi khi rất khó chẩn đoán. Chúng tôi báo cáo một trường hợp bệnh nam 64 tuổi có tình trạng cường cận giáp nguyên phát gây ra do u tuyến cận giáp lạc chỗ vùng trung thất trước. Bệnh nhân có biểu hiện lâm sàng ban đầu rất nặng nề bởi tình trạng hôn mê tăng áp lực thẩm thấu gây ra do đa niệu và canxi máu tăng. Chẩn đoán hình ảnh gồm xạ hình tuyến cận giáp và CT cổ ngực giúp chẩn đoán xác định vị trí lạc chỗ của u. Sau điều trị phẫu thuật, bệnh nhân hồi phục hoàn toàn.
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Các tài liệu tham khảo
1. Walulik A, Misiąg W, Gajdzis P, Szymańska-Chabowska A, Chabowski M (2022) Primary Hyperparathyroidism Secondary to Ectopic Parathyroid Adenoma: A Case Report. Adv Exp Med Biol 1374: 73-79.
2. Turner JJO (2017) Hypercalcaemia - presentation and management. Clinical Medicine 17(3): 270-273.
3. Kitada M, Yasuda S, Nana T, Ishibashi K, Hayashi S, Okazaki S (2016) Surgical treatment for mediastinal parathyroid adenoma causing primary hyperparathyroidism. J Cardiothorac Surg 11:44. doi: 10.1186/s13019-016-0461-8.
4. Joliat GR, Demartines N, Portmann L, Boubaker A, Matter M (2015) Successful minimally invasive surgery for primary hyperparathyroidism: influence of preoperative imaging and intraoperative parathyroid hormone levels. Langenbecks Arch Surg 400(8): 937-944.
5. Ruda JM, Hollenbeak CS, Stack BC (2005) A systematic review of the diagnosis and treatment of primary hyperparathyroidism from 1995 to 2003. Otolaryngol Head Neck Surg 132(3): 359-372.
6. Krakauer M, Wieslander B, Myschetzky PS, Lundstrøm A, Bacher T, Sørensen CH, Trolle W, Nygaard B, Bennedbæk FN (2016) A Prospective Comparative Study of Parathyroid Dual-Phase Scintigraphy, Dual-Isotope Subtraction Scintigraphy, 4D-CT, and Ultrasonography in Primary Hyperparathyroidism. Clin Nucl Med 41(2): 93-100.
7. Lee SW, Shim SR, Jeong SY, Kim SJ (2021) Direct Comparison of Preoperative Imaging Modalities for Localization of Primary Hyperparathyroidism: A Systematic Review and Network Meta-analysis. JAMA Otolaryngol Head Neck Surg 147(8):692-706.
8. Wilhelm SM, Wang TS, Ruan DT et al (2016) The American Association of Endocrine Surgeons Guidelines for Definitive Management of Primary Hyperparathyroidism. JAMA Surg 151(10): 959-968.
9. Goldfarb S, Agus ZS (1984) Mechanism of the polyuria of hypercalcemia. Am J Nephrol 4(2): 69-76.
10. Quamme GA (1982) Effect of hypercalcemia on renal tubular handling of calcium and magnesium. Can J Physiol Pharmacol 60(10): 1275-1280.
11. Cardella CJ, Birkin BL, Rapoport A (1979) Role of dialysis in the treatment of severe hypercalcemia: report of two cases successfully treated with hemodialysis and review of the literature. Clin Nephrol 12(6): 285-290.
12. Basok AB, Rogachev B, Haviv YS, Vorobiov M (2018) Treatment of extreme hypercalcaemia: the role of haemodialysis. BMJ Case Rep 2018:bcr2017223772. doi: 10.1136/bcr-2017-223772.
13. Calò PG, Pisano G, Loi G et al (2013) Intraoperative parathyroid hormone assay during focused parathyroidectomy: The importance of 20 minutes measurement. BMC Surg 13:36.
2. Turner JJO (2017) Hypercalcaemia - presentation and management. Clinical Medicine 17(3): 270-273.
3. Kitada M, Yasuda S, Nana T, Ishibashi K, Hayashi S, Okazaki S (2016) Surgical treatment for mediastinal parathyroid adenoma causing primary hyperparathyroidism. J Cardiothorac Surg 11:44. doi: 10.1186/s13019-016-0461-8.
4. Joliat GR, Demartines N, Portmann L, Boubaker A, Matter M (2015) Successful minimally invasive surgery for primary hyperparathyroidism: influence of preoperative imaging and intraoperative parathyroid hormone levels. Langenbecks Arch Surg 400(8): 937-944.
5. Ruda JM, Hollenbeak CS, Stack BC (2005) A systematic review of the diagnosis and treatment of primary hyperparathyroidism from 1995 to 2003. Otolaryngol Head Neck Surg 132(3): 359-372.
6. Krakauer M, Wieslander B, Myschetzky PS, Lundstrøm A, Bacher T, Sørensen CH, Trolle W, Nygaard B, Bennedbæk FN (2016) A Prospective Comparative Study of Parathyroid Dual-Phase Scintigraphy, Dual-Isotope Subtraction Scintigraphy, 4D-CT, and Ultrasonography in Primary Hyperparathyroidism. Clin Nucl Med 41(2): 93-100.
7. Lee SW, Shim SR, Jeong SY, Kim SJ (2021) Direct Comparison of Preoperative Imaging Modalities for Localization of Primary Hyperparathyroidism: A Systematic Review and Network Meta-analysis. JAMA Otolaryngol Head Neck Surg 147(8):692-706.
8. Wilhelm SM, Wang TS, Ruan DT et al (2016) The American Association of Endocrine Surgeons Guidelines for Definitive Management of Primary Hyperparathyroidism. JAMA Surg 151(10): 959-968.
9. Goldfarb S, Agus ZS (1984) Mechanism of the polyuria of hypercalcemia. Am J Nephrol 4(2): 69-76.
10. Quamme GA (1982) Effect of hypercalcemia on renal tubular handling of calcium and magnesium. Can J Physiol Pharmacol 60(10): 1275-1280.
11. Cardella CJ, Birkin BL, Rapoport A (1979) Role of dialysis in the treatment of severe hypercalcemia: report of two cases successfully treated with hemodialysis and review of the literature. Clin Nephrol 12(6): 285-290.
12. Basok AB, Rogachev B, Haviv YS, Vorobiov M (2018) Treatment of extreme hypercalcaemia: the role of haemodialysis. BMJ Case Rep 2018:bcr2017223772. doi: 10.1136/bcr-2017-223772.
13. Calò PG, Pisano G, Loi G et al (2013) Intraoperative parathyroid hormone assay during focused parathyroidectomy: The importance of 20 minutes measurement. BMC Surg 13:36.