著明な高カルシウム血症を呈した副甲状腺腺腫

Large Parathyroid Adenoma Presented with Prominent Hypercalcemia

　患者は49歳女性。全身倦怠感を訴えて来院し，尿路感染症の疑いで当科に紹介された。血清カルシウムが20.5mg／dlと著明に上昇しており，PTH-intact802pg／ml,PTH-C8.1ng／ml,HSPTH8,000pg／mlと副甲状腺機能亢進症であった。骨所見に異常はなく，画像診断で左側副甲状腺に4×1cm大の腫瘤を認めた。癌を疑い周囲組織を含め切除を行ったが，組織学的には均一な主細胞性腺腫で悪性所見はなく，術後は全ての値が速やかに正常化した。

A 49 year-old housewife complaining general fatigue, was found to have hyperparathyroidism with extraordinary hypercalcemia as high as 20.5mg/dl. Intact PTH, PTH-cterminal, high sensitivity PTH increased as 802pg/ml, 8.1ng/ml, and 8,000pg/ml. Cervical ultrasound and CT scan revealed 4×1cm parathyroid tumor behind the left lobe of the thyroid gland. Although malignancy was strongly suspected, and adjacent tissues were resected together With the tumor, histological examination revealed the tumor was adenoma. Increased serum PTH became normalized quickly after the surgery.