Srikantha Luxman, Amjad Esmael H, Beydoun Rafic
Department of Otolaryngology-Head and Neck Surgery, Detroit Medical Center, Detroit, MI, USA.
Department of Pathology, Detroit Medical Center, Detroit, MI, USA.
Case Rep Otolaryngol. 2020 Dec 29;2020:6805805. doi: 10.1155/2020/6805805. eCollection 2020.
Parathyroid adenomas are most commonly diagnosed when symptoms consistent with primary hyperparathyroidism arise. However, certain parathyroid glands may enlarge without such symptoms. Described here is a case in which a patient presented with acute signs of unilateral cervical point tenderness, dysphagia, and odynophagia. Calcium and parathyroid hormone levels tested within normal range. Imaging revealed an enlarged right-sided mass, with compression of the trachea-esophageal groove and potentially the right recurrent laryngeal nerve. Surgical excision was performed, and final pathology revealed an infarcted parathyroid adenoma. Clinical symptoms promptly resolved thereafter. Current NIH criteria for parathyroidectomy include various symptoms of hyperparathyroidism but do not include the above findings. Nonsecreting parathyroid adenomas rarely cause laryngeal symptoms, as this has only been documented once before.
甲状旁腺腺瘤最常在出现与原发性甲状旁腺功能亢进一致的症状时被诊断出来。然而,某些甲状旁腺可能会在没有这些症状的情况下肿大。本文描述了一例患者出现单侧颈部压痛、吞咽困难和吞咽痛等急性症状的病例。血钙和甲状旁腺激素水平检测在正常范围内。影像学检查发现右侧有一肿大肿块,压迫气管食管沟,可能还压迫右侧喉返神经。进行了手术切除,最终病理显示为梗死性甲状旁腺腺瘤。此后临床症状迅速缓解。美国国立卫生研究院目前的甲状旁腺切除术标准包括甲状旁腺功能亢进的各种症状,但不包括上述表现。无分泌功能的甲状旁腺腺瘤很少引起喉部症状,因为此前仅有一次相关记录。