Clinical Analysis Of Parathyroid Tumors:a Report Of36Cases

Objective:To investigate the diagnosis, preoperative location, surgery treatment and prognosis of parathyroid tumors.Method:Retrospective analysis of the clinical data of36cases of parathyroid tumors in Xiangya Hospital from May1996to April2009.Results:The age span of this group was from14to59with average age36.5years old. There were15male and21female respectively with ratio of1:1.4. All cases presented with single tumor including6from left upper,18from left lower,4from right upper and8from right lower parathyroid. Only3cases of parathyroid cyst were diagnosed on the first impression correctly and misdiagnosis rate is91.7%. The pathology of36parathyroid tumors including30adenoma,1adenocarcinoma and5cysts. The former two accompanied with primary hyperparathyroidism (PHPT) and5cases of parathyroid cyst was nonfunction. Serum calcium of31case and PTH of30cases from all31PHPT cases were higher than normal and decreased to normal level after operation and the PTH decrease is significant (P<0.01). Except1case was diagnosed upper mediastinum cyst, the other35cases were all correctly located of tumor preoperative through ultrasonic, CT scan and99mTc-MIBI.30patients undergone single lateral exploration and excision of the tumor including2ispilateral thyroidectomy, which presented with ispilateral thyroid nodules;1case of parathyroid adenocarcinoma undergone single exploration and excision of the tumor during the first operation and reoperation of functional cervical lymph node dissection was performed when lymph node metastasis was found4months later;5cases of parathyroid cyst were excised.32cases (88.9%) acquired follow-up and no case found relapse and lesion-missing.Conclusion:1. Parathyroid tumor with slow onset and complex clinical manifestation has a higher misdiagnosed rate. Serum calcium, phosphorus and PTH detection is helpful to diagnosis of primary hyperparathyroidism.2. B ultrasonic is the preferred selected for location of tumor and CT scan,99mTc-MIBI are helpful to further locate the tumor.3. Surgical operation is the best treatment for parathyroid tumor and the curative effect is fine.