Garrahy Aoife, Hogan David, O'Neill James Paul, Agha Amar
Department of Endocrinology, Beaumont Hospital, Dublin, Ireland.
Department of Otolaryngology, Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland.
BMC Endocr Disord. 2017 Jun 21;17(1):35. doi: 10.1186/s12902-017-0186-2.
Spontaneous haemorrhage into a parathyroid adenoma is a rare and potentially life-threatening presentation.
We report the case of a 45 year old female recently diagnosed with primary hyperparathyroidism who presented with chest discomfort and acute airway compromise due to spontaneous extracapsular haemorrhage into a parathyroid adenoma. Computed tomography (CT) imaging showed a hypopharyngeal haematoma extending 10 cm into the superior mediastinum. Surgical decompression of the cyst followed by enbloc resection of the parathyroid tumour was performed after elective intubation. Calcium and parathyroid hormone (PTH) levels had fallen prior to surgery and remain normal post-operatively.
Spontaneous parathyroid haemorrhage should be considered in any patient with unexplained spontaneous cervical haemorrhage, particularly if there is a history of hyperparathyroidism. Initial evaluation of such patients should include serum calcium and PTH as well as imaging.
甲状旁腺腺瘤自发性出血是一种罕见且可能危及生命的表现。
我们报告一例45岁女性病例，该患者近期被诊断为原发性甲状旁腺功能亢进，因甲状旁腺腺瘤自发性包膜外出血出现胸部不适和急性气道受压。计算机断层扫描（CT）成像显示下咽血肿向上纵隔延伸10厘米。在择期插管后，对囊肿进行手术减压，随后整块切除甲状旁腺肿瘤。术前钙和甲状旁腺激素（PTH）水平已下降，术后保持正常。
对于任何原因不明的自发性颈部出血患者，尤其是有甲状旁腺功能亢进病史的患者，应考虑自发性甲状旁腺出血。对此类患者的初步评估应包括血清钙和PTH以及影像学检查。
