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甲状腺腺瘤脑梗塞模仿甲状腺出血囊:一个看似无辜的情况,可以危及生命
Jasmine Van de Kerkhof1, Jacqueline Bijnens1, Frank De Geeter2
1Department of ENT, H&N Surgery, General Hospital Sint-Jan, Bruges, Belgium.
Endocrinology, diabetes & metabolism case reports
|December 8, 2023
概括
副甲状腺性脑梗塞是一种罕见的部出血和疼痛的原因,可以模仿甲状腺囊. 通过超声波和18F-胆PET/CT即时成像有助于诊断这种情况并指导手术干预.
科学领域:
- 内分泌学 在内分泌学.
- 手术病理学手术病理学
- 核医学就是核医学.
背景情况:
- 初级甲状腺功能障碍症通常伴有高血症.
- 副甲状腺性脑梗塞,或副甲状腺腺瘤内的出血,是急性部症状的罕见原因,通常模仿甲状腺病理.
- 这种情况可以呈现为突然发作的疼痛部质量或出血.
研究的目的:
- 突出甲状腺性脑梗塞作为急性部出血的差异诊断,呈现为出血的甲状腺囊.
- 强调高级成像在偏甲状腺性脑梗塞的诊断和管理中的作用.
- 讨论临床表现,诊断工作,和副甲状腺性脑梗塞的手术考虑.
主要方法:
- 一个患有突然发作的疼痛部胀的患者的病例介绍.
- 诊断成像包括超声波,99mTc-pertechnetate/sestamibi扫描以及18F-胆PET/CT.
- 对甲状腺上下腺功能障碍的生物化学评估.
- 手术探索和组织病理学检查.
主要成果:
- 这名患者出现了疼痛的部质量和轻度的原发性甲状腺功能障碍症,最初怀疑是甲状腺囊出血.
- 超声波和核医学扫描没有确定性,但18F-胆PET/CT将病变确定为甲状腺腺瘤.
- 组织病理学证实了副甲状腺腺瘤与显著的出血.
- 患者成功接受了副甲状腺切除术和右甲状腺叶切除术.
结论:
- 在高热血症的背景下,宫疼痛和出血应该引起对甲状腺瘤的怀疑.
- 18F-胆PET/CT是一种有价值的工具,用于区分甲状腺侧状腺病变和甲状腺病理,当传统的成像是模两可的.
- 及时的手术干预至关重要,以防止复发性出血,并管理诸如结石病和骨质疏松症等并发症.
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