Thórhallsdóttir Hrund, Asgeirsson Kristján Skúli, Olafsdóttir Agústa, Gudbjartsson Tómas
Skurdlaekningasvid.
Laeknabladid. 2010 Jul-Aug;96(7-8):469-72. doi: 10.17992/lbl.2010.0708.307.
A 72 year old gentleman presented to the emergency department with symptoms of diffuse joint and muscular pain, fatigue and diminished memory. Serum calcium and parathyroid hormone levels were raised, consistent with primary hyperparathyroidism. No abnormality was found on an ultrasound scan of the neck. However, a sestamibi scan suggested a possible adenoma in the anterior mediastinum, which on computed tomography (CT) scan was 1.5 cm in size. A partial upper sternotomy was performed in order to excise the adenoma and his symptoms disappeared within several weeks. This case highlights the variable and commonly nonspecific symptoms of primary hyperparathyroidism and the less well known fact that parathyroid adenoma may occasionally be found intrathoracically.
一位72岁的男性因弥漫性关节和肌肉疼痛、疲劳及记忆力减退症状前往急诊科就诊。血清钙和甲状旁腺激素水平升高，符合原发性甲状旁腺功能亢进。颈部超声扫描未发现异常。然而，锝-99m甲氧基异丁基异腈（sestamibi）扫描提示前纵隔可能存在腺瘤，计算机断层扫描（CT）显示该腺瘤大小为1.5厘米。为切除腺瘤进行了部分上胸骨切开术，数周内他的症状消失。该病例凸显了原发性甲状旁腺功能亢进症状的多样性及通常的非特异性，以及甲状旁腺腺瘤偶尔可在胸腔内发现这一鲜为人知的事实。
