甲状腺内異所性副甲状腺腫による原発性副甲状腺機能亢進症の1症例

A case of primary hyperparathyroidism caused by intrathyroidal parathyroid adenoma

はじめに

　原発性副甲状腺機能亢進症は適切な病的副甲状腺の局在診断が重要であり，手術療法が第一選択となる疾患である。今回，われわれは，頸部超音波検査，^99mTc-MIBIシンチグラフィー，CTによる局在診断を行い甲状腺内の異所性副甲状腺腫を認め，甲状腺葉切除を施行し病変を摘除することによって良好な経過を得た原発性副甲状腺機能亢進症症例を経験したので，文献的考察を加えて報告する。

　A 71-year-old female, referred to our department, showed an increased value on Ca and intact-PTH. Under ultrasonography, a hypoechoic intrathyroid nodule was detected. CT pointed out a low density mass, and MIBI scintigraphy showed accumulation of the isotope in the left lobe of the thyroid gland. We suspected that primary hyperparathyroidism was caused by an intrathyroidal parathyroid adenoma and left thyroid lobectomy was performed. After the operation, hypercalcemia was improved rapidly. Pathological diagnosis was an intrathyroidal parathyroid adenoma.