上皮小体嚢腫による上皮小体機能亢進症の1例—Parathyroid hormone分泌に関する考察

A CASE OF PRIMARY PARATHYROIDISM DUE TO PARATHYROID CYST WITH SPECIAL REFERENCE TO THE PARATHYROID HORMONE SECRETION

緒言

　上皮小体嚢腫は，先天的な発生病理機転をもつものと腺腫が二次的変化を生じたものに分類され^1），前者は機能亢進を伴わず，後者は高い上皮小体ホルモン（PTH）活性と高Ca血症を伴うとされてきたが，血清Ca,Pや，PTHの測定が行われるようになり，従来の簡単な分類だけでこれらの疾患を理解することが困難になつてきた。ここに典型的な腺腫を含んだ上皮小体嚢腫の1例を報告するとともに，嚢腫におけるPTH分泌機序などについての考察を試みた。

A twenty four year-old female was explored for the parathyroid adenoma because of high serum Ca and parathyroid hormone levels after successful surgery of the urolithiasis.

A thumb-tip-sized adenoma with cyst formation was extirpated, which had been arisen from left upper parathyroid. Postoperative course was satisfactory including normalized serum Ca level.

Some parathyroid cysts without any histological evidence of adenoma or hyperplasia showed high serum Ca and parathyroid hormone levels.