Clin Exp Otorhinolaryngol.  2008 Mar;1(1):46-48. 10.3342/ceo.2008.1.1.46.

Non-Functional Parathyroid Adenoma Presenting as a Massive Cervical Hematoma: A Case Report

• Shim WS
• Kim IK
• Yoo SD
• Kim DH

• KMID: 1486036
• DOI: http://doi.org/10.3342/ceo.2008.1.1.46

Abstract

Parathyroid adenoma usually manifests with symptoms related to hypercalcemia, such as urinary stone and bone fracture. It may also present with asymptomatic hypercalcemia. However, spontaneous cervical hematoma may occur very rarely as a result of extracapsular hemorrhage of a cervical parathyroid adenoma causing acute painful cervical swelling, bruising, dyspnea, hoarseness and dysphagia. We report a 44-year-old woman who manifested as a spontaneous cervical hematoma without any clinical evidence of hyperparathyroidism.

Keyword

Neck; Hematoma; Parathyroid neoplasm

MeSH Terms

Acute Pain
Adult
Deglutition Disorders
Dyspnea
Female
Fractures, Bone
Hematoma
Hemorrhage
Hoarseness
Humans
Hypercalcemia
Hyperparathyroidism
Neck
Parathyroid Neoplasms
Urinary Calculi

Figure

• 

  Fig. 1 The CT scan shows cervical hematoma (arrow), obliterating the fat plane between the right thyroid, right common carotid artery (A). The ultrasonography shows a 2 cm sized heterogenous echogenic mass in the right infrathyroid region (B).

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  Fig. 2 The follow-up CT scan at 3 weeks. Cervical hematoma shown in previous CT scan is nearly resolved, and there is a 2 cm sized peripheral rim enhancing cystic mass in the right tracheoesophageal groove near the thoracic inlet.

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  Fig. 3 Intraoperative a ovoid cystic mass (arrow) in the right tracheoesophageal groove compressing the right recurrent laryngeal nerve (asterisk).

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  Fig. 4 Histologic examination shows extracapsular hemorrhage and parathyroid adenoma (H&E stain ×50). The mass is mainly composed of fairly uniform, polygonal chief cells with small, centrally placed nuclei.

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