ObjectiveTo explore the clinical characteristics, diagnosis and treatment of ectopic thyroid gland (ETG) so as to reduce the misdiagnosis and improper treatment. MethodsAccording to the patients who were definitely diagnosed ETG by pathology from 2002 to 2010 in our hospital, their clinical and pathological data were retrospectively analyzed. ResultsThere were 14 patients, 4 cases of male and 10 cases of female. Five patients had clinical symptoms. Eight cases were diagnosed before operation and six cases were diagnosed by pathology after operation. There were 4 cases were malignancy and 10 were benign. Three cases of differentiated ectopic thyroid carcinoma patients and 1 normal position's thyroid had papillary carcinoma patient accepted TSH suppression treatment after operation, 4 benign patients and 1 ectopic thyroid medullary carcinoma patient accepted levothyroxine substitution treatment after operation, and the other 5 benign patients did not accept any treatment after operation. Nine patients who accepted follow-up in 1-10 years had orthobiosis, and the malignancy patients without recurrence and metastasis. ConclusionsETG usually reveal no any special clinical features. For any masses from root of tongue to mediastinum, especially cervical masses, should be carefully check whether there are thyroid in normal position, and to exclude ETG. The color Doppler ultrasound, thyroid radioactive scanning, thyroid function tests, computed tomography, and fine needle aspiration cytology are all important examination measures. Due to the ETG may occur the same lesions as the normal position's thyroid, so once it is be definitly diagnosed, the treatment should be based on patient's age, position, size, and type of ETG, and nature of the lesions to select follow-up observation, operative treatment, levothyroxine replacement or therapeutic inhibition of TSH, and 131I therapy.
ObjectiveTo analysis the clinical symptoms, diagnosis, and treatment of primary hyperparathyroidism (PHPT). MethodsA retrospective study was made in consecutive patients with PHPT who performed operation and had integral data between January 2004 to December 2012 in West China Hospital. ResultsThe 136 cases were composed of 52 cases (38.23%) bone types, 17 cases (12.50%) nephrocalcinosis, 7 cases (5.15%) skeletal and renal involvements, 24 cases (17.65%) asymptomatic primary hyperparathyroidism, and 36 cases (26.47%) combined with other clinical symptoms. The preoperative parathyroid hormone (PTH) levels were (106.20±88.88) pmol/L (6.91-390 pmol/L) and serum calcium were (3.12±0.66) mmol/L (2.15-5.77 mmol/L). The coincidence rate between the examinations preoperation and pathology:B type ultrasound was 75.00%, 99Tcm-MIBI scan was 85.29%, ultrasound and 99Tcm-MIBI combined with computerized tomography (CT) scan was 86.76%. Pathology presentation:129 patients (94.85%) were benign lesions, 7 cases (5.15%) were parathyroid carcinoma. Of the 129 patients, 114 cases (95.80%) were single parathyroid adenoma, 5 cases (4.20%) were multiple parathyroid adenoma or combined parathyroid hyperplasia, 10 cases (7.75%) were parathyroid hyperplasia. Of the patients, the PTH level decreased to below normal upper limit within 3 days after surgery in 124 cases (91.18%). One hundred and twenty-four cases (91.18%) were followed-up. The follow-up time was 6-112 months, a median follow-up time was 49 months. Twelve patients (8.82%) were lost to follow-up, 2 patients (1.47%) with carcinoma recurrence, the rest patients without recurrence and metastasis. Three patients (2.20%) with parathyroid carcinoma died. Of the 3 patients, 2 died of systemic metastasis of parathyroid carcinoma in 18 and 23 months after surgery, 1 died of cardiovascular accident in 19 months after surgery. ConclusionSurgical excision of the lesion parathyroid tissue is the most effective treatment for PHPT.