ObjectiveTo explore the diagnosis and treatment features of parathyroid carcinoma (PTC). MethodsThe clinical data of 7 cases of parathyroid carcinoma treated from January 1993 to April 2014 were analyzed retrospectively. ResultsAll of the 7 patients had symptoms of hyperparathyroidism. Four patients had palpable neck mass. The average serum calcium level of preoperation was 3.07 mmol/L (2.35-4.98 mmol/L). The average parathyroid hormone (PTH) level was 1 181.5 pg/mL (78.4-2 061.7 pg/mL), which elevated 17 times the upper limit of normal. One case had operation in other hospital and six cases in Jishuitan hospital. The tumors located in the left inferior parathyroid gland in 3 cases, 2 cases of right lower parathyroid, and right superior parathyroid gland in 1 cases. One case underwent parathyroidectomy, parathyroidectomy including ipsilateral thyroid lobe or part of it was performed in 5 cases. Of 5 cases, 1 case was added central compartment lymphadenectomy. Three cases of postoperative tumor recurrence underwent reoperation, of which 1 case recurred 3 times. Two cases died. The remining 5 had survived until now, had survived for 5 years in 3 cases. ConclusionsA comprehensive approach with clinical presentation, serum calcium and PTH levels, B-ultrasonography, 99Tcm-MIBI, intraoperation aberrant findings, and histopathology offers help to accurate diagnosis of parathyroid carcinoma. Surgery is en bloc resection of the primary lesion. Recurrence needs reoperation, and long-term follow-up is advised.
目的结合近期收治的1例肝脏血管周上皮样细胞肿瘤(perivascular epitheliod cell tumor,PEComa)的病例特点,总结该疾病的诊治体会。 方法回顾分析2013年9月笔者所在医院成功收治的1例肝脏原发PEComa的诊治过程,并结合既往文献报道,总结和复习该疾病的临床特点以及处理方法。 结果肝脏PEComa较为罕见,起病隐匿,症状缺乏特异性,临床诊断困难,多依赖病理学检查证实,手术切除是有效的治疗手段。 结论提高本病影像学特征的认识有助于术前肿瘤性质的判断,本病预后较好,但术后仍需要长期密切观察随访。