Kihara M, Yokomise H, Yamauchi A, Irie A, Matsusaka K, Miyauchi A
Second Department of Surgery, Kagawa Medical University, Kita-gun, Japan.
Surg Today. 2001;31(3):222-4. doi: 10.1007/s005950170172.
We report an unusual case of spontaneous rupture of a parathyroid adenoma causing cervical hemorrhage. A 60-year-old woman presented to our hospital after the sudden development of extensive ecchymosis of her neck and upper anterior chest wall. Computed tomography (CT) scanning revealed a hematoma in the left retrotracheal space, and laboratory examinations revealed significant hypercalcemia, hypophosphatemia, and a high level of intact parathyroid hormone. Primary hyperparathyroidism was diagnosed, but it was not until the hematoma had subsided, 4 months after her initial presentation, that a parathyroid adenoma was revealed by CT. An operation was performed, and a parathyroid adenoma with hemosiderin deposition was histologically diagnosed. Although this phenomenon is unusual, all endocrine surgeons should be well aware of the possibility of its occurrence.
我们报告了一例罕见的甲状旁腺腺瘤自发性破裂导致颈部出血的病例。一名60岁女性在颈部和上前胸壁突然出现广泛瘀斑后就诊于我院。计算机断层扫描（CT）显示气管后间隙左侧有血肿，实验室检查显示有明显的高钙血症、低磷血症和高水平的甲状旁腺激素原。诊断为原发性甲状旁腺功能亢进，但直到初次就诊4个月后血肿消退，CT才发现甲状旁腺腺瘤。进行了手术，组织学诊断为伴有含铁血黄素沉积的甲状旁腺腺瘤。尽管这种现象不常见，但所有内分泌外科医生都应充分意识到其发生的可能性。
