二次性副甲状腺過形成が原因と考えられた深頸部血腫の1症例

Deep Cervical Hematoma Derived from Secondary Hyperplasia of the Parathyroid Gland―A Case Report―

I．はじめに

　慢性腎不全患者の長期透析例においては，しばしば二次性副甲状腺機能亢進症をきたすことが知られている^1～6）。

　今回われわれは，頸部腫脹，紫斑，気道狭窄で発症した慢性腎不全患者の深頸部血腫に対して血腫除去術を行い，病理学的検査で過形成副甲状腺が出血の原因と考えられた症例を経験したので，若干の文献的考察を含めて報告する。

　An 86-year-old woman presented with a 5-day-history of left cervical swelling and purpura. She had chronic renal failure accompanied with secondary hyperparathyroidism,and receiving hemodialysis for 4 years. She also showed laryngeal edema and purpura. Either clinical symptoms or laboratory data showed no signs of inflammation. CT revealed a ring-enhanced mass located posteriorly to the left lobe of the thyroid gland. These findings suggested a deep cervical hematoma,and she underwent removal of the hematoma and tracheostomy under general anesthesia. Histopathological examination of the surgical specimen showed hyperplastic parathyroid tissue scattered in coagulated red blood cells,indicating that the source of hemorrhage was the hyperplastic parathyroid gland. Diagnosis and treatment of deep cervical hematoma derived from rupture of the parathyroid gland were reviewed in the literature.