日本内分泌学会雑誌
Online ISSN : 2186-506X
Print ISSN : 0029-0661
ISSN-L : 0029-0661
腎性副甲状腺機能亢進症に合併した甲状腺微小癌の検討
井上 聖士, 吾妻 真幸, 平林 俊明, 依藤 良一, 稲垣 王子, 森 頴太郎, 藤田 嘉一, 覚道 健一, 小林 彰, 隈 寛二, 坂井 瑠実, 西岡 正登, 駒場 啓太郎, 申 曽沫
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1986 年 62 巻 10 号 p. 1194-1202

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For twenty long-term hemodialysis patients with medically uncontrolled hyperparathyroidism, subtotal parathyroidectomy (PTX) was performed and histological examination was done for 17 out of them, suspected of thyroid disease from operative findings. Thyroid carcinomas were found in 5 out of 17 patients by biopsied specimens of thyroids. Histological findings of carcinomas were follicular (2 cases) and papillary types (3 cases). In all cases, carcinomas were in occult state and the sizes of carcinomas of 4 cases were small being a diameter less than 10mm. Among others, findings of follicular adenoma (2 cases) and chronic thyroiditis (1 case) were obtained.
The incidence rate of thyroid carcinoma in this report seemed to be rather high as the incidence diagnosed from biopsied specimen at operation.
Several factors such as immunological incompetence accompanied by renal failure, metabolic abnormalities of cells induced by parathyroid dysfunction and accelerated aging are considered to be involved as a cause of increased incidence of thyroid carcinoma in hemodialysis patients with hyperparathyroidism.

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