Momma yensua Parathyroid Kokoram ho ade. Nsuro, momma yɛnkasa!

Yɛn nyinaa nya nsakrae nketenkete ne ɔhaw ahorow wɔ yɛn nipadua mu bere ne bere mu, ɛnte saa? Ebia ɛyɛ akuru ketewaa bi a ɛwɔ kɔn mu, anaasɛ ebetumi ayɛ biribi te sɛ ɔbrɛ a ntease biara nnim, anaasɛ sukɔm de bere nyinaa. Ɛwom sɛ saa nneɛma yi mu dodow no ara nyɛ biribi a ɛsɛ sɛ ɛhaw adwene de, nanso wɔ nsɛm a ɛntaa nsi mu no, ebetumi ayɛ ayaresa tebea bi ho sɛnkyerɛnne titiriw. Ɛnnɛ yɛrebɛka kokoram bi a ɛho yɛ na kakra ho asɛm, nanso ɛho hia paa sɛ yɛn nyinaa hu. Ɛno ne kokoram a ɛba parathyroid ntini mu, a wɔ aduruyɛ mu frɛ no parathyroid kokoram , anaa `(Parathyroid Carcinoma)`.

Dɛn ne Parathyroid Kokoram?

Sɛ yɛbɛka no tiawa a, parathyroid kokoram yɛ kokoram a ɛntaa nsi koraa a ɛba wo parathyroid ntini no ntini mu. Mpɛn pii no, wo parathyroid ntini no wɔ thyroid ntini a ɛte sɛ ntontom a ɛwɔ wo kɔn anim no akyi.

Wɔnkyekyɛ parathyroid kokoram mu nkyekyɛmu anan (``afã anan din nhyehyɛe``) te sɛ kokoram ahorow afoforo. Mmom no, nnuruyɛfo kyekyɛ kokoram no mu atitiriw abiɛsa:

• Localized: Eyi kyerɛ sɛ kokoram no wɔ wo parathyroid gland nkutoo mu. Ɛtɔ mmere bi a, ebia na ɛtrɛw kakra kɔ ntini a atwa ho ahyia no mu. Eyi kyerɛ sɛ kokoram no da so ara wɔ beae biako.
• Metastatic: Eyi ne bere a kokoram no atrɛw akɔ wo nipadua no afã afoforo te sɛ ntini a ɛma mogya tu, mmerɛbo, ahurututu, nnompe, anaa dwensɔtwaa. Nnipa a wɔwɔ parathyroid kokoram no mu 10% kosi 30% na kokoram no trɛw (ɛtrɛw kɔ mmeae afoforo) bere a wɔahu sɛ wɔwɔ kokoram no. Mmeae a ɛtaa ba ne ahurututu, nnompe, anaa mmerɛbo.
• Ɛsan ba bio: Eyi ne bere a kokoram no san ba wɔ ayaresa a edi kan akyi – mpɛn pii no bere a wɔayɛ oprehyɛn ayi kokoram no akyi. Nnipa a wɔwɔ parathyroid kokoram no mu bɛboro fã benya kokoram a ɛte sɛɛ. Mpɛn pii no, kokoram no san ba wɔ mfe abien kosi anum akyi wɔ oprehyɛn a edi kan no akyi. Nanso, ɛtɔ mmere bi a ebetumi asan aba akyiri yi mfe 20.

Dɛn ne saa parathyroid ntini ahorow yi?

Yɛn mu dodow no ara wɔ parathyroid ntini anan a ne kɛse te sɛ pea. Sɛnea yɛadi kan aka no, eyinom wɔ thyroid ntini no akyi. Te sɛ thyroid ntini no, parathyroid ntini no yɛ wo endocrine nhyehyɛe no fã. Ɛtɔ da bi a, saa parathyroid ntini yi betumi akɔ wo menewam anaa wo moma so mpo. Wɔfrɛ eyi ectopic.Wɔfrɛ parathyroid ntini no parathyroid ntini, a ɛkyerɛ sɛ enni baabi a ɛsɛ sɛ ɛwɔ.

Wo parathyroid ntini no dwumadi titiriw ne sɛ ɛbɛhwɛ calcium dodow a ɛwɔ wo mogya mu no so denam parathyroid hormone (PTH) a ɛbɛyɛ so . Ɛtɔ mmere bi a, wo parathyroid ntini biako anaa nea ɛboro saa fi ase yɛ parathyroid hormone (PTH) yi pii dodo. Wɔfrɛ saa tebea yi Primary Hyperparathyroidism (pHPT) . Sɛ wɔyɛ PTH pii a, calcium dodow a ɛwɔ wo mogya mu no kɔ soro. Wɔfrɛ saa tebea yi hypercalcemia .

Nsonsonoe bɛn na ɛda parathyroid kokoram ne parathyroid adenoma ntam?

Parathyroid adenoma yɛ nyin a ɛnyɛ hu a ɛnyɛ kokoram wɔ parathyroid ntini no mu. Nanso, parathyroid kokoram yɛ nkwammoaa a ɛyɛ hu a ɛnyɛ kokoram a ɛba wo parathyroid ntini mu. Wɔ nyarewa a ɛbata parathyroid ntini ho no mu no, parathyroid adenoma abu so kɛse sen parathyroid kokoram.

Nanso ade a ɛho hia ni: Wɔ tebea abien yi nyinaa mu, parathyroid kokoram ne parathyroid adenoma, wo parathyroid ntini no betumi ayɛ adwuma dodo na ama parathyroid hormone (PTH) pii aba. Afei, sɛnea yɛadi kan aka no, hypercalcemia ba. Saa hypercalcemia yi betumi apira wo nipadua ne w’akwahosan. Enti, aduru a wɔtaa de sa parathyroid kokoram, ne parathyroid adenomas nso ne sɛ wɔbɛyɛ oprehyɛn ayi parathyroid ntini a ɛyɛ adwuma boro so no afi hɔ.

Wɔ nnuruyɛfo mpo fam no, ebetumi ayɛ den sɛ wobehu ntɛm ara sɛ ebia ɛyɛ parathyroid adenoma anaasɛ parathyroid carcinoma. Esiane sɛ abien no nyinaa nkwammoaa betumi ayɛ pɛ nti, bere a wɔayɛ oprehyɛn ayi parathyroid ntini a ɛyɛ adwuma boro so no afi hɔ akyi no, ɛho hia sɛ wɔyɛ nhwehwɛmu foforo de kyerɛ sɛ ebia ɛyɛ adenoma anaasɛ kokoram.

Dɛn ne hypercalcemia? Ɔkwan bɛn so na ɛne parathyroid kokoram wɔ abusuabɔ?

Hypercalcemia yɛ bere a wo mogya mu calcium dodow dɔɔso sen sɛnea ɛte daa no. Nnipa a wɔwɔ parathyroid kokoram taa nya hypercalcemia. Nea enti a ɛte saa ne sɛ kokoram no ma wo parathyroid ntini no yɛ adwuma boro so na ɛma parathyroid hormone (PTH) pii ba. Parathyroid hormone (PTH) na ɛma calcium dodow a ɛwɔ wo mogya mu no yɛ adwuma yiye. Enti, sɛ wowɔ parathyroid hormone (PTH) pii dodo a, wo mogya mu calcium dodow bɛkɔ soro.

Hypercalcemia betumi apira w’akwahosan ne wo nipadua. Enti, ɛho hia yiye sɛ wɔsa hypercalcemia a parathyroid kokoram no de ba no ne kokoram no ankasa nso.

So parathyroid kokoram ahorow wɔ hɔ?

Yiw, parathyroid kokoram ahorow atitiriw abien na ɛwɔ hɔ.

1. Nea ɛtaa ba: Wɔ eyi mu no, kokoram nkwammoaa ma wo parathyroid ntini no yɛ parathyroid hormone (PTH) pii dodo na ɛma ɛkɔ mogya no mu. Eyi ma calcium dodow a ɛwɔ wo mogya mu no kɔ soro.

2. Parathyroid carcinoma a ɛnyɛ adwuma: Wɔsan frɛ eyi sɛ ``parathyroid carcinoma a ɛnyɛ adwuma''. Eyi yɛ soronko wɔ ahorow afoforo no ho. Efisɛ, nnipa a wɔwɔ kokoram a ɛte sɛɛ no ​​nni parathyroid hormone (PTH) anaa calcium dodow a ɛkɔ soro wɔ wɔn mogya mu. Saa ɔkwan yi ho yɛ na yiye, ɛba wɔ ayarefo a wɔwɔ parathyroid kokoram a ennu 10% mu .

Sɛ wohu kokoram a ɛwɔ parathyroid mu wie a, wɔyɛ nhwehwɛmu foforo de hu sɛ ebia ɛwɔ baabiara , ɛtrɛw kɔ mmeae afoforo , anaasɛ ɛsan ba bio . Sɛnea yɛadi kan aka no, wɔmfa afã anan a wɔde di dwuma ma kokoram afoforo no nni dwuma mma eyi.

Hena na ɛda adi sɛ obenya parathyroid kokoram?

Saa kokoram yi ka mmea ne mmarima pɛpɛɛpɛ. Wɔtaa hu wɔ nnipa a wɔadi boro mfe 30 mu .

Saa yare yi abu so dɛn?

Parathyroid kokoram yɛ yare a ɛntaa nsi koraa. Susuw ho hwɛ, ɛyɛ kokoram nyinaa mu 0.005% pɛ. Afei nso, parathyroid kokoram yɛ nyarewa a ɛfa parathyroid ntini ho nyinaa mu 0.5% kosi 1% . Enti, eyi ho yɛ na ankasa.

Dɛn ne nneɛma a ɛde Parathyroid Kokoram ba?

Nokwarem no, wonnya nhuu ade pɔtee biara a ɛde parathyroid kokoram ba.

Nanso, wobu awosu mu tebea horow a ɛntaa nsi (i.e., a wonya fi abusua mu) a edidi so yi sɛ nneɛma a ɛde kokoram yi ba:

• Endocrine neoplasia a ɛwɔ nipadua no mu pii a ɛyɛ I (MEN1) .
• Abusua mu hyperparathyroidism a atew ne ho (FIHP) .
• Hyperparathyroidism-anom akisikuru a ɛma obi nya akisikuru

Bio nso, sɛ wɔde mframa a ano yɛ den ayɛ wo ti anaa wo kɔn mu bere bi a atwam a, ebetumi ama asiane a ɛwɔ hɔ sɛ wubenya parathyroid kokoram no nso ayɛ kɛse.

Dɛn ne Parathyroid Kokoram ho sɛnkyerɛnne?

Mpɛn pii no, parathyroid kokoram ho sɛnkyerɛnne ne hypercalcemia ho sɛnkyerɛnne a efi mu ba. Nsɛnkyerɛnne ne nsɛnkyerɛnne a ɛkyerɛ sɛ obi anya hypercalcemia no bi ne:

• Ɛho hia sɛ wɔtow wo ho mpɛn pii sen sɛnea wɔtaa tow (toto a wɔtaa tow) .
• Sukɔm dee wo ho sen sɛnea ɔtaa yɛ
• Akisikuru ne ɔfe
• Sɛnea wɔtaa yɛ noƆkɔm a ɛnte nka
• Ayamtim
• Ɔbrɛ kɛse a wɔte nka
• Te a wobɛte nka sɛ woayɛ basaa
• Wo werɛ fi anaasɛ obi a ɔnkae ade
• Ntini mu yaw, mmerɛwyɛ, ne/anaasɛ akisikuru

Parathyroid kokoram ho sɛnkyerɛnne afoforo a ebetumi aba:

• Sɛ wowɔ akisikuru wɔ wo kɔn mu
• Ɛnne a ɛsakra anaasɛ ɛyɛ dede
• Ɛyɛ den sɛ wobɛmene aduan

Sɛ wowɔ saa sɛnkyerɛnne ahorow yi mu biako anaa nea ɛboro saa a, nsuro sɛ wubesusuw sɛ akyinnye biara nni ho sɛ ɛyɛ parathyroid kokoram. Wobetumi ahu saa sɛnkyerɛnne ahorow yi nso wɔ tebea afoforo pii mu. Nanso, sɛ biribi te sɛ eyi kɔ so a, ɛbɛyɛ papa sɛ wobɛkɔ oduruyɛfo nkyɛn akɔhwehwɛ afotu.

Ɔkwan bɛn so na wohu Parathyroid Kokoram?

Ɛtɔ mmere bi a, parathyroid kokoram a wobehu no betumi ayɛ den kakra. Ade biako nti a ɛte saa ne sɛ parathyroid adenoma a ɛnyɛ kokoram ne parathyroid kokoram de no betumi ayɛ pɛ.

Wɔtaa hu parathyroid kokoram bere a wɔde oprehyɛn ayi wo parathyroid ntini a ɛnyɛ ne kwan so, a ɛyɛ adwuma boro so no afi hɔ (`parathyroidectomy`), na wɔakɔ so ahwehwɛ ntini no mu akyi. Ɛtɔ mmere bi a, oduruyɛfo a ɔyɛ oprehyɛn no tumi hu parathyroid kokoram bere a wɔreyɛ oprehyɛn no.

Nhwehwɛmu bɛn na wɔyɛ de hu yare no?

Sɛnea yɛadi kan aka no, wɔtaa hu parathyroid kokoram bere a wɔahu sɛ wowɔ hyperparathyroidism titiriw , na wɔyɛ oprehyɛn yi parathyroid ntini a ɛnyɛ ne kwan so na ɛyɛ adwuma boro so no fi hɔ. Ɛtɔ mmere bi a, oduruyɛfo a ɔyɛ oprehyɛn no tumi hu parathyroid kokoram bere a wɔreyɛ oprehyɛn no.

Ansa na wɔbɛyɛ wo oprehyɛn de ayi wo parathyroid ntini a ɛyɛ adwuma dodo no, ebia wɔbɛyɛ wo nhwehwɛmu te sɛ eyinom:

• Mogya mu calcium nhwehwɛmu
• Mogya mu PTH nhwehwɛmu
• Parathyroid scan - Eyi taa yɛ radioactive sestamibi scan ne/anaasɛ CT scan.

Sɛ wohu sɛ wowɔ parathyroid kokoram a, wo duruyɛfo betumi ahyɛ sɛ wɔnyɛ mfoninitwa nhwehwɛmu te sɛ eyinom na ama wɔahu sɛ kokoram no atrɛw (atrɛw) akɔ wo nipadua no afã afoforo anaa:

• CT scan (computerized tomography scan): CT scan de X-ray ne kɔmputa yɛ wo nipadua ho mfonini pii a ɛwɔ afã abiɛsa (3D).
• MRI scan (MRI - mfonini a wɔde magnetic resonance yɛ):MRI scan de magnet kɛse, radio asorɔkye, ne kɔmputa na ɛyɛ wo nipadua ho mfonini a ɛkɔ akyiri. Ɛmfa X-ray (mframa) nni dwuma.

Dɛn ne nnuru a wɔde sa parathyroid kokoram?

Ayaresa titiriw a wobetumi apaw ama parathyroid kokoram ne oprehyɛn a wɔde yi parathyroid ntini a kokoram wom no fi hɔ (`en bloc resection`). Sɛ parathyroid kokoram atrɛw (atrɛw) a, ebia ɛho behia nso sɛ wo oprehyɛn duruyɛfo no yi ntini a atwa wo parathyroid ntini anaa kokoram ntini ho ahyia no fi wo nipadua no afã afoforo.

Wobetumi de oprehyɛn akwan a edidi so yi adi dwuma wɔ parathyroid kokoram ho:

• En bloc resection: Wɔ saa adeyɛ yi mu no, oduruyɛfo a ɔyɛ oprehyɛn no yi wo parathyroid ntini no nyinaa ne capsule a atwa ho ahyia no. Ɛtɔ mmere bi a, wobetumi ayi thyroid ntini a ɛwɔ ɔfã koro no ara ne parathyroid ntini a kokoram wom no fã, ne ntini, ntini, ne ntini a atwa ho ahyia no nso.
• Tumor debulking: Wɔ saa adeyɛ yi mu no, oduruyɛfo a ɔyɛ oprehyɛn no yi akisikuru no fã kɛse biara sɛnea obetumi. Ebia wɔrenyi akisikuru bi mfi hɔ koraa.
• Metastasectomy: Wɔ eyi mu no, oduruyɛfo a ɔyɛ oprehyɛn no yi kokoram biara a atrɛw (atrɛw) akɔ ntini afoforo ne/anaasɛ akwaa ahorow a ɛwɔ wo nipadua mu, sɛ nhwɛso no, ahurututu mu.

So mɛyɛ nnuru a wɔde sa yare anaa mframa a wɔde sa yare?

Wɔntaa mfa nnuru a wɔde sa yare ne mframa a wɔde sa yare nni dwuma mfa nsa parathyroid kokoram. Wo duruyɛfo besi gyinae sɛ ebia nnuru a wɔde sa yare ne/anaasɛ mframa a wɔde sa yare no yɛ ɔkwan a ɛfata ma wo anaa.

So aduru bi wɔ hɔ a wɔde sa parathyroid kokoram?

Mprempren, nnuru pɔtee biara nni hɔ a wɔde sa parathyroid kokoram. Nnipa pii a wɔwɔ parathyroid kokoram no nya hypercalcemia ho sɛnkyerɛnne. Esiane sɛ hypercalcemia betumi apira wo nti, wo duruyɛfo betumi akyerɛw wo nnuru a edidi so yi mu biako anaa nea ɛboro saa ama hypercalcemia:

• Nnuru a wɔde yɛ aduru (Cinacalcet - Sensipar®) .
• Bisphosphonates a wɔde yɛ nneɛma
• Denosumab (Denosumab - XGEVA®) a ɛwɔ nipadua no mu.

Sɛ wowɔ hypercalcemia ho sɛnkyerɛnne a emu yɛ den a, ebia wo duruyɛfo bɛkamfo akyerɛ sɛ wɔmfa wo nkɔ ayaresabea ntɛm ara na fi ase fa nsu a wɔde fa ntini mu (IV) ne ayaresa afoforo.

So me parathyroid kokoram no betumi asan aba bio?

Yiw, nnipa a wɔahu sɛ wɔwɔ parathyroid kokoram no mu bɛboro fã betumi asan anya kokoram no bio.Kokoram taa san ba wɔ mfe kakraa bi mu – mpɛn pii no ɛyɛ mfe abien kosi anum. Nanso wɔ tebea horow bi mu no, ebetumi asi mfe du du pii (mfe 20 anaa nea ɛboro saa) wɔ bere a wodii kan huu wo yare no na wɔasa wo yare no akyi.

So kokoram yi betumi atrɛw (atrɛw) akɔ nipadua no afã afoforo?

Yiw, parathyroid kokoram betumi atrɛw (atrɛw) akɔ wo nipadua no afã afoforo. Nnipa a wɔwɔ parathyroid kokoram no mu 10% kosi 30% na kokoram no atrɛw dedaw (ɛkɔ mmeae afoforo) bere a wɔahu sɛ wɔwɔ kokoram no. Wɔ tebea horow yi mu no, kokoram no taa trɛw kɔ w’ahurututu, nnompe, anaa mmerɛbo mu. Nanso, ebetumi atrɛw akɔ wo ntini anaa wo dwensɔtwaa mu nso.

Dɛn ne parathyroid kokoram ho nkɔmhyɛ?

Parathyroid kokoram ho nkɔmhyɛ gyina sɛnea oprehyɛn a wɔde beyi parathyroid ntini no awie bere a wodi kan hu sɛ wowɔ no so, efisɛ ayaresa a ɛto so abien te sɛ mframa a wɔde sa yare ne nnuru a wɔde sa yare no sua.

Wɔ nnipa a wɔwɔ parathyroid kokoram a wɔayɛ wɔn en bloc resection na wɔn margins a enye fam no, nkwa a wonya no dɔɔso te sɛ 90% wɔ mfe anum akyi wɔ oprehyɛn a edi kan no akyi. Nkwa dodow nso dɔɔso te sɛ 67% wɔ mfe du wɔ oprehyɛn a edi kan no akyi.

Nnipa bɛboro fã a wɔahu sɛ wɔwɔ parathyroid kokoram na wɔyɛ wɔn oprehyɛn de yi ntini no fi hɔ no bɛsan anya kokoram no bio. Wɔ nsɛm yi mu no, mpɛn pii no, kokoram no san ba wɔ mfe abien kosi anum akyi wɔ oprehyɛn a edi kan no akyi. Nanso, ebetumi asan aba mfe du du pii akyi.

So wobetumi asiw Parathyroid Kokoram ano?

Nea ɛyɛ awerɛhow no, ɔkwan biara nni hɔ a wonim a wɔbɛfa so asiw parathyroid kokoram ano. Afei nso, ɔkwan biara nni hɔ a wɔbɛfa so atew asiane a ɛwɔ hɔ sɛ obi benya yare yi so. Sɛ obi a ɔwɔ w’abusua mu anya parathyroid ntini mu yare a, ɛbɛyɛ papa sɛ wo ne wo duruyɛfo bɛkasa.

Nsɛm bɛn na ɛsɛ sɛ mibisa me duruyɛfo?

Sɛ wowɔ parathyroid kokoram a, ebia wobɛpɛ sɛ wubisa wo duruyɛfo nsɛm te sɛ eyinom:

• So kokoram no atrɛw akɔ akyiri sen me parathyroid ntini no?
• Dɛn ne aduru a eye sen biara a wɔde sa parathyroid kokoram?
• Asiane ne nsunsuanso bɔne bɛn na ɛwɔ ayaresa no mu?
• So m’abusua wɔ asiane mu sɛ wobenya parathyroid kokoram?
• So metumi anya parathyroid kokoram bio?
• So mewɔ asiane mu sɛ menya kokoram ahorow afoforo?
• Ɔhwɛ bɛn na mihia akyi wɔ ayaresa akyi?
• So ɛsɛ sɛ mihu nsɛnnennen ho sɛnkyerɛnne ahorow?

Nea etwa to no, nneɛma a ɛsɛ sɛ yɛkae

Sɛ wohu sɛ wowɔ kokoram a, ebetumi ayɛ ade a ɛyɛ hu. Nanso kae sɛ, .W’aduruyɛfo kuw no wɔ ha sɛ wɔbɛboa wo na wɔakyerɛ wo ayaresa a eye sen biara. Ɛwom sɛ mprempren oprehyɛn nkutoo ne parathyroid kokoram ayaresa de, nanso nhwehwɛmu ne kokoram ayaresa renya nkɔso bere nyinaa. Ebia nnuruyɛ mu sɔhwɛ bi mpo wɔ hɔ a wubetumi de wo ho ahyɛ mu Enti, nsuro sɛ wubebisa wo duruyɛfo nsɛm afa wo parathyroid kokoram no ho. Hwɛ hu sɛ wɔakyerɛkyerɛ biribiara mu wɔ ɔkwan a wobɛte ase so.

` Parathyroid Kokoram, Parathyroid Ntini, Hypercalcemia, Parathyroid Hormone, PTH, Kokoram Nsɛnkyerɛnne, Kokoram Ayaresa, Oprehyɛn