Primary Hyperparathyroidism in Adolescence: A Case Report

青少年原發性副甲狀腺機能亢進症－病例報告

10.6200/TCMJ.2017.14.3.10

陳重光(Chung-Kuang Chen)；陳火木(Huo-Mu Chen)；黃博琪(Po-Chi Huang)

Body weight loss ； Hyperparathyroidism ； Parathyroid adenoma ； 體重減輕 ； 原發性副甲狀腺機能亢進症 ； 副甲狀腺良性腫瘤

北市醫學雜誌

14卷3期（2017 / 09 / 30）

356 - 364

英文

A 19-year-old man presented to our outpatient clinic with body weight loss of about 15 kg with unknown cause in the past 1 year. He underwent a series of examinations including thyroid ultrasonography, and primary hyperparathyroidism with mild hypercalcemia and Vitamin D deficiency was impressed. An extrathyroidal tumor posterior to the lower pole of the left thyroid lobe was also discovered by thyroid ultrasonography. For re-localizing the tumor, Tc-99m MIBI parathyroid scan with SPECT/CT was carried out at another branch hospital and the co-registered images showed an extrathyroidal hot focus similar to ultrasonography finding. Open surgery was carried out and a yellow well-circumscribed tumor measuring 2.0 cm in size in the posterior aspect of lower pole of left thyroid gland was removed. A benign parathyroid adenoma was diagnosed pathologically. This patient regained body weight progressively after tumor excision and remained asymptomatic for follow-up visits after hospital discharge. This case demonstrates the integration process to diagnose and treat difficult cases through inter-branch horizontal medical technology in Taipei City Hospital.

一位19歲男性病患因過去一年原因不明體重減輕達15公斤求診，經包括甲狀腺超音波等一系列檢查後，懷疑病人有原發性副甲狀腺機能亢進症導致高血鈣及維他命D缺乏，超音波檢查也顯示一個腫瘤在甲狀腺左葉下方。跨院區副甲狀腺核子醫學掃描檢查再定位後，經手術取出2公分黃色界限分明的腫瘤送驗。病理報告確診為一良性副甲狀腺腺瘤。術後病人體重逐漸回復且後續追蹤沒有發現其他症狀。此案例證明台北市立聯合醫院各院區透過跨院區橫向醫療技術整合，成功完成對困難個案的診療過程。