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误诊的巨大甲状旁腺囊肿:中央区域颈部肿块的鉴别诊断。

Misdiagnosed giant parathyroid cyst: differential diagnosis of a neck mass of the central region.

机构信息

Division of Endocrine Surgery, Department of Gastroenterologic, Endocrine-Metabolic and Nephro-Urologic Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy

Dipartimento di scienze mediche e chirurgiche, Policlinico Universitario Agostino Gemelli, Rome, Italy.

出版信息

BMJ Case Rep. 2022 Jun 22;15(6):e245501. doi: 10.1136/bcr-2021-245501.

Abstract

Parathyroid cysts (PCs) are rare benign lesions representing between the 0.08% and the 0.34% of the neck masses going on surgery. They should be considered in the differential diagnosis of neck masses, especially in the differential diagnosis of the cystic anterior neck masses.Approximately 300 cases of PC are reported within the international literature.The gold standard for diagnosis is the evidence of high-level intact parathyroid hormone in cystic fluid. It is important to diagnose PCs before surgery, not intraoperatively, in order to avoid unnecessary surgeries or superfluous excision of part of the thyroid gland and prevent the patient from iatrogenic hypothyroidism.A surgical approach is required in those patients with large-sized cysts, relapses despite needle aspirations or if it causes hyperparathyroidism.We describe a case report of a patient, initially misdiagnosed with a thyroid cyst swelling, who instead had a giant non-functioning PC, which produced dyspnoea or dysphagia.

摘要

甲状旁腺囊肿(PCs)是罕见的良性病变,占手术治疗的颈部肿块的 0.08%至 0.34%。在颈部肿块的鉴别诊断中,尤其是在囊性前颈部肿块的鉴别诊断中,应考虑到甲状旁腺囊肿。在国际文献中报道了大约 300 例甲状旁腺囊肿病例。诊断的金标准是囊性液中高水平完整甲状旁腺激素的证据。在手术前而不是手术中诊断 PCs 非常重要,以避免不必要的手术或甲状腺部分过度切除,并防止患者发生医源性甲状腺功能减退症。对于那些囊肿较大、经针吸治疗后仍复发或引起甲状旁腺功能亢进的患者,需要手术治疗。我们描述了一例患者的病例报告,该患者最初被误诊为甲状腺囊肿肿胀,而实际上是巨大的无功能甲状旁腺囊肿,导致呼吸困难或吞咽困难。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c08d/9226963/7c2531fdd824/bcr-2021-245501f01.jpg

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