Parathyroid adenoma presenting with spontaneous cervical and anterior mediastinal hemorrhage: A case report.

Abstract

RATIONALE:

Spontaneous anterior cervical or mediastinal hemorrhage is a rare presentation of parathyroid adenoma.

PATIENT CONCERNS:

A 69-year-old woman presented with neck hematoma and dysphagia and was found to have a soft tissue mass adjacent to her thyroid gland as seen on MRI and neck ultrasound.

DIAGNOSIS:

Laboratory testing demonstrated elevated calcium and parathyroid hormone supporting diagnosis of parathyroid adenoma.

INTERVENTIONS:

She underwent right inferior parathyroidectomy and en bloc right hemithyroidectomy due to significant fibrosis.

OUTCOMES:

Pathology confirmed hypercellular parathyroid and normal thyroid tissue. Postoperatively, patient's calcium and parathyroid hormone levels had normalized.

LESSONS:

In conclusion, imaging may not always be specific in identifying the source of neck hematoma and so laboratory studies should be done to rule out parathyroid adenoma as the underlying etiology.

• Authors: Sohini Khan, Charles C Choe, Ahmed Shabaik, Michael Bouvet
• Journal: Medicine (Medicine (Baltimore)) Vol. 98 Issue 5 Pg. e14347 (Feb 2019) ISSN: 1536-5964 [Electronic] United States
• PMID: 30702621 (Publication Type: Case Reports, Journal Article)

Topics

• Adenoma (complications, diagnosis, surgery)
• Aged
• Female
• Hematoma (etiology)
• Humans
• Mediastinal Diseases (etiology)
• Neck
• Parathyroid Neoplasms (complications, diagnosis, surgery)
• Parathyroidectomy
• Thyroidectomy