PDF(Pubmed)
Abstract：
UNASSIGNED: Severe dysphagia is a rare presenting symptom of primary hyperparathyroidism, whereas the most common hypercalcemia-related causes include gastrointestinal symptoms, such as anorexia, constipation, and pancreatitis. This case presentation aimed to describe swallowing difficulty as a leading symptom of hypercalcemia.
UNASSIGNED: A 62-year-old man experienced vomiting, dysphagia bordering with aphagia, and 20-kg weight loss in a 2-month period. The parathyroid hormone and serum calcium levels were 102 pmol/L (reference range, 1.8-7.9 pmol/L) and 4.12 mmol/L (reference range, 2.14-2.53 mmol/L), respectively. Ultrasound-guided exploration of the neck revealed a large, rounded hypoechoic mass inferior to the left thyroid lobe, which contained parathyroid tissue on fine-needle aspiration cytology examination. Contrast-enhanced neck computed tomography revealed a mass measuring 3.6 × 2.6 × 2.5 cm behind the left thyroid lobe, alongside massive ventral spondylophytes of the cervical spine at the level of the postcricoid segment of the hypopharynx. Magnetic resonance imaging confirmed ventral tissue displacement due to spondylophyte size and location. Surgical exploration of the left side of the neck was performed, and the left lower parathyroid gland weighing 9.07 g was excised. Pathohistologic findings verified a parathyroid gland adenoma. The postoperative values showed parathyroid hormone and serum calcium levels at 4.54 pmol/L and 2.25 mmol/L, respectively.
UNASSIGNED: The pathophysiology of dysphagia in hypercalcemia is not fully elucidated. In this case, the patient\'s improvement after surgery implies a plausible connection between hypercalcemia and dysphagia, suggesting a causal relationship.
UNASSIGNED: Although aphagia is not a typical presenting symptom of parathyroid adenoma, it should be noted in the differential diagnosis.
UNASSIGNED: A 62-year-old man experienced vomiting, dysphagia bordering with aphagia, and 20-kg weight loss in a 2-month period. The parathyroid hormone and serum calcium levels were 102 pmol/L (reference range, 1.8-7.9 pmol/L) and 4.12 mmol/L (reference range, 2.14-2.53 mmol/L), respectively. Ultrasound-guided exploration of the neck revealed a large, rounded hypoechoic mass inferior to the left thyroid lobe, which contained parathyroid tissue on fine-needle aspiration cytology examination. Contrast-enhanced neck computed tomography revealed a mass measuring 3.6 × 2.6 × 2.5 cm behind the left thyroid lobe, alongside massive ventral spondylophytes of the cervical spine at the level of the postcricoid segment of the hypopharynx. Magnetic resonance imaging confirmed ventral tissue displacement due to spondylophyte size and location. Surgical exploration of the left side of the neck was performed, and the left lower parathyroid gland weighing 9.07 g was excised. Pathohistologic findings verified a parathyroid gland adenoma. The postoperative values showed parathyroid hormone and serum calcium levels at 4.54 pmol/L and 2.25 mmol/L, respectively.
UNASSIGNED: The pathophysiology of dysphagia in hypercalcemia is not fully elucidated. In this case, the patient\'s improvement after surgery implies a plausible connection between hypercalcemia and dysphagia, suggesting a causal relationship.
UNASSIGNED: Although aphagia is not a typical presenting symptom of parathyroid adenoma, it should be noted in the differential diagnosis.
摘要：
■严重吞咽困难是原发性甲状旁腺功能亢进的一种罕见症状，而最常见的高钙血症相关原因包括胃肠道症状，如厌食症，便秘,和胰腺炎。此病例介绍旨在描述吞咽困难是高钙血症的主要症状。
■一名62岁男子出现呕吐,吞咽困难与失语症接壤，在2个月内减重20公斤。甲状旁腺激素和血清钙水平为102pmol/L（参考范围，1.8-7.9pmol/L）和4.12mmol/L（参考范围，2.14-2.53mmol/L)，分别。超声引导下的颈部探查显示，甲状腺左叶下方的圆形低回声肿块，在细针穿刺细胞学检查中包含甲状旁腺组织。对比增强颈部计算机断层扫描显示左甲状腺叶后方3.6×2.6×2.5cm的肿块，在下咽的后环状节段的水平上，与颈椎的大量腹侧脊椎phytes并排。磁共振成像证实腹侧组织移位是由于脊椎的大小和位置。对左侧颈部进行了手术探查，切除重量为9.07g的左下甲状旁腺。病理组织学发现证实为甲状旁腺腺瘤。术后甲状旁腺激素和血清钙水平分别为4.54pmol/L和2.25mmol/L，分别。
■高钙血症吞咽困难的病理生理学尚未完全阐明。在这种情况下,患者在手术后的改善暗示了高钙血症和吞咽困难之间的合理联系，暗示了因果关系。
■虽然失语症不是甲状旁腺腺瘤的典型症状，在鉴别诊断中应注意。
■一名62岁男子出现呕吐,吞咽困难与失语症接壤，在2个月内减重20公斤。甲状旁腺激素和血清钙水平为102pmol/L（参考范围，1.8-7.9pmol/L）和4.12mmol/L（参考范围，2.14-2.53mmol/L)，分别。超声引导下的颈部探查显示，甲状腺左叶下方的圆形低回声肿块，在细针穿刺细胞学检查中包含甲状旁腺组织。对比增强颈部计算机断层扫描显示左甲状腺叶后方3.6×2.6×2.5cm的肿块，在下咽的后环状节段的水平上，与颈椎的大量腹侧脊椎phytes并排。磁共振成像证实腹侧组织移位是由于脊椎的大小和位置。对左侧颈部进行了手术探查，切除重量为9.07g的左下甲状旁腺。病理组织学发现证实为甲状旁腺腺瘤。术后甲状旁腺激素和血清钙水平分别为4.54pmol/L和2.25mmol/L，分别。
■高钙血症吞咽困难的病理生理学尚未完全阐明。在这种情况下,患者在手术后的改善暗示了高钙血症和吞咽困难之间的合理联系，暗示了因果关系。
■虽然失语症不是甲状旁腺腺瘤的典型症状，在鉴别诊断中应注意。
