1 Objective To summarize the features of myxedema coma complicated with operations on the sella tumors, and discuss the preoperative prevention and clinic treatment.

2 Myxedema coma is rare but potentially lethal, the symptoms and signs are many and are often insidious .

3 Conclusions: Depending on the analysis and treatment of this case, the nodules on shanks might originate from myxedema caused by hypothyroidism and can be cured by eliminating the origin of a disease.

4 Here we report a rare case of a 68 years old male with primary hypothyroidism with myxedema coma and respiratory failure.

5 The clinical presentation varies from a subclinical form with insignificant symptoms to the most extreme form of myxedema coma with respiratory failure.

6 Giving thyrine before operation even when the patiens' thyroid function was normal, can prevent myxedema coma due to damaging pituitary or hypophysial stalk during the operation.

7 Among other theories, experts have proposed that Henry suffered from Type II diabetes, syphilis, an endocrine problem called Cushing's syndrome, or myxedema, which is a byproduct of hypothyroidism.

8 It can be relevant to the deposit of mucopolysaccharides and mucoproteins in the myocardium, leading to myocardial myxedema .

9 Two years later, the patient deeloped chest pain; pericardial effusion was detected, leading to a diagnosis of myxedema caused by hypothyroidism.