Nottingham University Hospitals NHS Trust, Nottingham, UK.
Sherwood Forest Hospitals NHS Foundation Trust, Sutton-In-Ashfield, UK
BMJ Case Rep. 2022 Feb 8;15(2):e247069. doi: 10.1136/bcr-2021-247069.
Parathyroid carcinoma is very rare in pregnancy. Clinical features are similar to primary hyperparathyroidism. A 38-year-old pregnant woman had repeated hospital admissions for palpitations, headaches, dizziness and polydipsia. Blood investigations showed severe hypercalcaemia with raised parathyroid hormone and 24-hour ECG showed ventricular bigeminy and premature ventricular contractions. Neck ultrasound showed a lesion in the right thyroid lobe. Consequently, she underwent an en bloc resection of the right parathyroid and thyroid lobe at 23 weeks gestation. Histology results confirmed parathyroid cancer. This case highlights the complexities of identifying hypercalcaemia in pregnancy due to the overlapping features with common disorders of pregnancy. Early recognition and timely surgical management can prevent maternal and fetal complications. Also, the case demonstrates the value of interprofessional collaboration between different specialities in providing quality care and improving outcomes. An abridged version of this case was presented at European Congress of Endocrinology 2021.
甲状旁腺癌在妊娠中非常罕见。其临床特征与原发性甲状旁腺功能亢进相似。一名 38 岁孕妇因心悸、头痛、头晕和多尿反复住院。血液检查显示严重高钙血症伴甲状旁腺激素升高，24 小时心电图显示室性二联律和室性期前收缩。颈部超声显示右侧甲状腺叶有病变。因此，她在妊娠 23 周时接受了右甲状旁腺和甲状腺叶的整块切除术。组织学结果证实为甲状旁腺癌。本病例强调了在妊娠中识别高钙血症的复杂性，因为其与妊娠常见疾病的特征有重叠。早期识别和及时的手术治疗可以预防母婴并发症。此外，该病例还展示了不同专业之间的跨专业协作在提供优质护理和改善结局方面的价值。该病例的简本曾在 2021 年欧洲内分泌学会大会上展示。
