多发性内分泌腺瘤病2A型三例

发布时间：2018-04-17 21:54

本文选题：MEN2A + 甲状腺髓样癌　；参考：《浙江大学》2015年硕士论文

【摘要】：目的总结3例多发性内分泌腺瘤病2A型的诊治经过,结合文献对本病的发病机制、临床表现、诊断及治疗等加以探讨,以便在今后的诊疗中做到早诊断、早治疗。方法回顾分析2012-2014年浙江大学医学院附属第一医院收治的3例MEN2A的临床资料。结果 3例患者均有明显的临床表现,以儿茶酚胺增多的表现为主,如阵发性血压升高、心悸、出汗、头晕头痛、恶心呕吐、震颤等。三者均存在肾上腺嗜铬细胞瘤,有不同程度的甲状腺异常,不伴甲状旁腺增生、腺瘤,经相关生化、影像及病理检查,临床诊断为MEN2A,并予手术治疗,1例患者甲状腺癌及肾上腺嗜铬细胞瘤术后有复发。结论当患者出现甲状腺、肾上腺及甲状旁腺增生或腺瘤等多种内分泌腺体肿瘤时需考虑本病,RET基因检测是诊断本病的金标准,若无条件行基因检测,生化和影像检查是临床上常用的辅助诊断方法。目前治疗主要以手术切除为主,对于本病,提倡早诊断、早治疗。
[Abstract]:PurposeThe diagnosis and treatment of 3 cases of multiple endocrine adenomatosis type 2A were summarized. The pathogenesis, clinical manifestation, diagnosis and treatment of this disease were discussed in order to make early diagnosis and treatment in the future.MethodThe clinical data of 3 cases of MEN2A admitted in the first affiliated Hospital of Zhejiang University Medical College from 2012 to 2014 were retrospectively analyzed.ResultAll the 3 patients had obvious clinical manifestations, such as paroxysmal hypertension, palpitation, sweating, dizziness and headache, nausea and vomiting, tremor and so on.All three had adrenal pheochromocytoma with different degrees of thyroid abnormalities, without parathyroid hyperplasia, adenoma, and related biochemical, imaging and pathological examination.One patient with thyroid carcinoma and adrenal pheochromocytoma recurred after operation.ConclusionWhen the patient has thyroid, adrenal, parathyroid hyperplasia or adenoma, it should be considered that the detection of RET gene is the gold standard for the diagnosis of this disease.Biochemical and imaging examination are commonly used in clinical diagnosis.At present, the main treatment is surgical resection, for this disease, early diagnosis, early treatment.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R736;R440

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