Patel Nilesh P, Wright S Carter, Bergman Simon
Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1070, USA.
Am J Otolaryngol. 2009 May-Jun;30(3):216-8. doi: 10.1016/j.amjoto.2008.04.006. Epub 2008 Sep 21.
Metastatic calcification (MC) commonly results secondary to phosphorus and calcium dysregulation in end-stage renal disease (ESRD). Only once before has MC been reported to involve a true vocal cord. A 35-year-old man with ESRD and secondary hyperparathyroidism was evaluated for hoarseness. Three years ago, he underwent a total parathyroidectomy with parathyroid autograft to the forearm. Simultaneously, he had a left lobe thyroidectomy that displayed a papillary thyroid carcinoma. Since that time, he continued to have hyperphosphatemia and hypocalcemia. Laryngoscopy displayed a small papillomatous lesion on the right true vocal cord. He underwent excision of the vocal cord lesion; histologic examination demonstrated benign squamous epithelium with extensive submucosal calcification. In patients with ESRD with secondary dysregulation of serum phosphorus to calcium level balance, MC may involve variable anatomical locations, including the true vocal cords. Regarding histologic findings, pathologists must consider malignancies associated with calcification, mimicking a benign process.
转移性钙化（MC）通常继发于终末期肾病（ESRD）时的磷和钙调节异常。此前仅有一次报道MC累及真正的声带。一名患有ESRD和继发性甲状旁腺功能亢进的35岁男性因声音嘶哑接受评估。三年前，他接受了甲状旁腺全切术并将甲状旁腺自体移植到前臂。同时，他进行了左侧甲状腺叶切除术，术中发现甲状腺乳头状癌。自那时起，他持续存在高磷血症和低钙血症。喉镜检查显示右侧真声带有一个小的乳头状病变。他接受了声带病变切除术；组织学检查显示为良性鳞状上皮，伴有广泛的黏膜下钙化。在血清磷与钙水平平衡继发性调节异常的ESRD患者中，MC可能累及不同的解剖部位，包括真正的声带。关于组织学发现，病理学家必须考虑与钙化相关的恶性肿瘤，它们可能会模仿良性过程。
