^(99)Tc^(m)-MIBI显像阴性的原发性甲状旁腺功能亢进症合并甲状腺乳头状癌的治疗选择  

Management of ^(99)Tc^(m)-MIBI-negative primary hyperparathyroidism complicated with papillary thyroid carcinoma

作　　者：于静雯 张曦 刘海蔚[1] Yu Jingwen;Zhang Xi;Liu Haiwei(Department of Endocrinology,Hainan General Hospital,Haikou 570311,China;Department of Cardiology,Hainan General Hospital,Haikou 570311,China)

机构地区：[1]海南省人民医院内分泌科,海口570311 [2]海南省人民医院心血管内科,海口570311

出　　处：《中华内分泌代谢杂志》2025年第1期61-64,共4页Chinese Journal of Endocrinology and Metabolism

基　　金：海南省临床医学中心建设资助项目(琼卫医函(2021)276号)。

摘　　要：原发性甲状旁腺功能亢进症(PHPT)是临床上相对常见的一种内分泌疾病。对于该疾病的诊断、定性易,但常出现锝-99m-甲氧基异丁基异腈(^(99)Tc^(m)-MIBI)显像阴性而导致定位困难的情况,常导致临床治疗的困局,即是否选择手术治疗。本文列举的2例^(99)Tc^(m)-MIBI显像阴性的PHPT患者均同时合并甲状腺乳头状癌(PTC),进行传统手术探查后,手术医生成功定位并切除了甲状旁腺功能亢进症的病灶,并对PTC进行了相应处理,术后随访患者恢复良好。本文尝试对积极手术的原因加以分析,以期提高对此类情形的临床认知。Primary hyperparathyroidism(PHPT)is a relatively common endocrine disorder in clinical practice.While the diagnosis and characterization of this condition are straightforward,cases with negative ^(99)Tc^(m)-methoxyisobutylisonitrile(^(99)Tc^(m)-MIBI)imaging often complicates lesion localization,posing a clinical challenge in determining whether surgical intervention is warranted.This paper presents two cases of PHPT with negative ^(99)Tc^(m)-MIBI imaging,both diagnosed with papillary thyroid carcinoma(PTC).Following bilateral neck exploration,the surgeons successfully localized and excised the hyperparathyroid lesions and provided appropriate treatment for PTC.Postoperative follow-up indicated favorable recovery in both patients.This article aims to dive deeply into the necessity of surgical intervention and enhance clinical management of these cases.

关 键 词：原发性甲状旁腺功能亢进症 ^(99)Tc^(m)-MIBI显像阴性 甲状腺乳头状癌 

分 类 号：R581.1[医药卫生—内分泌] R736.1[医药卫生—内科学]