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

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

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Bibliographic Details
Published in:Medicine (Baltimore) 2019-02, Vol.98 (5), p.e14347-e14347
Main Authors: Khan, Sohini, Choe, Charles C., Shabaik, Ahmed, Bouvet, Michael
Format: Article
Language:English
Subjects:
Adenoma - complications
Adenoma - diagnosis
Adenoma - surgery
Aged
Clinical Case Report
Female
Hematoma - etiology
Humans
Mediastinal Diseases - etiology
Neck
Parathyroid Neoplasms - complications
Parathyroid Neoplasms - diagnosis
Parathyroid Neoplasms - surgery
Parathyroidectomy
Thyroidectomy
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Summary:Spontaneous anterior cervical or mediastinal hemorrhage is a rare presentation of parathyroid adenoma. 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. Laboratory testing demonstrated elevated calcium and parathyroid hormone supporting diagnosis of parathyroid adenoma. She underwent right inferior parathyroidectomy and en bloc right hemithyroidectomy due to significant fibrosis. Pathology confirmed hypercellular parathyroid and normal thyroid tissue. Postoperatively, patient's calcium and parathyroid hormone levels had normalized. 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.
ISSN:0025-7974
1536-5964
DOI:10.1097/MD.0000000000014347