シンチスキャンで局在診断が可能であつた上皮小体腺腫の1例

SUCCESSFUL PREOPERATIVE DIAGNOSIS OF THE LOCALIZATION OF ADENOMA OF THE PARATHYROID GLAND BY SCINTISCAN

緒言

　上皮小体機能亢進症の術前局在診断は容易ではない。しかし，近年の診断法の進歩により，かなり小さな腫瘤まで局在診断ができるようになつてきた。われわれは²⁰¹Tlシンチグラフィーと^99mTcO₄—シンチグラフィーを用いたサブトラクション法によつて，術前局在診断が可能であつた症例を経験した。今回この症例を検討し，上皮小体機能亢進症の局在診断法について若干の文献的考察を加えて報告する。

Successful preoperative diagnosis of the localization of adenoma of the parathyroid in 59-year-old female with hyperparathyroidism by means of double tracer scanning and computerized image subtrac-tion was described. She had been suffering from recurrent urolithiasis and was referred to our clinic because of hypercalcemia and hypophosphatemia in November 1983. The level of serum calcium was 11. 2 mg/dl and inorganic serum phosphorus 2.1 mg/dl. The activity of serum alkaline phosphatase was within normal limits. Urinary calcium excretion was elevated to the level of 262 mg/day under low calcium diet (300 mg/day).