甲狀腺腫擴展伴隨功能亢進之異位甲狀旁腺

Extending Goiter Accompanied by Ectopic hyperparathyroidism

一位51歲男性病人，患有左側甲狀腺腫，擴展至前縱隔腔和後縱隔腔。而後檢查到異位甲狀旁腺功能亢進症。以上這些內分泌和解剖異常，導致這病人高血壓、頭痛、呼吸困難、高血鈣症和輸尿管結石。他同時也有雙側陰囊水腫。最初，異位甲狀旁腺功能亢進被忽略了，他只接受部分胸骨切開術，完成擴展至胸內之甲狀腺腫的切除手術，以及雙側陰囊水腫手術。最初被忽略的異位甲狀旁腺也在10個月後，使用胸腔鏡完成切除手術。經過這兩次手術和一次體外衝擊波碎石術，他的上述症狀得到緩解，血鈣也恢復正常。

A 51-year-old male patient had ectopic hyperparathyroidism and concomitant left goiter. The left goiter extended to the anterior and posterior mediastinum. These endocrine and anatomic conditions induced hypertension, headache, dyspnea, hypercalcemia, and urinary tract stones. He also had bilateral huge hydroceles. Initially, the ectopic hyperparathyroidism was ignored because of unknown serum calcium. He then underwent complete resection of the extending goiter via a partial sternotomy. Bilateral hydrocelectomies were also concomitantly performed. The initially neglected ectopic hyperparathyroidism was treated using thoracoscopic parathyroidectomy ten months later. All symptoms were relieved and his serum calcium was restored to normal level following these surgeries and extracorporeal shock wave lithotripsy.