Abstract
Surgical procedures for primary hyper-parathyroidism
Shuichi Yakuwa＊, Kuniaki Chida, Kazuya Kurakami, Masayuki Kaneko, Naoto Araki, Kyohei Kamata, Kikyo Shiomizu, Ryo Fukase, Yuko Abiko, Keizo Kudo, Tsukasa Ito
＊Department of Otolaryngology, Head and Neck Surgery, Yamagata University Faculty of Medicine, Yamagata
Primary hyperparathyroidism（PHPT）is mostly caused by parathyroid adenoma, but rarely by parathyroid carcinoma. We studied surgical cases of PHPT. The subjects were 20 patients who underwent surgery with a diagnosis of PHPT during a 10-year period from October 2013 to September 2023. The following four risk factors were considered：（1）palpable cervical mass （tumor diameter≧3 cm）,（2）bone lesions, （3）serum Ca level≧12 mg/dL, and（4）hyper iPTH≧three times the upper limit of normal. Three patients fulfilled at least three items, and the remaining 17 patients fulfilled less than two items. One patient with three or more risk factors was diagnosed as parathyroid carcinoma on postoperative pathological examination.
はじめに
原発性副甲状腺機能亢進症（primary hyperparathyroidism：PHPT）は，有病率が0.1％以上と推定される比較的頻度の高い内分泌疾患である。PHPTの原因疾患の多くは副甲状腺腫であり，副甲状腺癌は約1％とまれである1～3）。副甲状腺癌は播種の危険性があるため，細胞診は原則禁忌とされ，悪性が疑われても術前に副甲状腺癌を診断することはしばしば困難である。今回，副甲状腺腫および副甲状腺癌の臨床的特徴を明らかにするとともに，当科におけるPHPT手術治療の効果について検討を行ったので報告する。