Korean J Head Neck Oncol.  2019 Nov;35(2):27-30. 10.21593/kjhno/2019.35.2.27.

Parathyroid Adenoma Causing Spontaneous Cervical Hematoma: A Case Report and Review of Literature

• Shin TH
• Park SS
• Won CS
• Kim MK
• Kim MS

• KMID: 2469231
• DOI: http://doi.org/10.21593/kjhno/2019.35.2.27

Abstract

Parathyroid adenoma can cause extracapsular bleeding. In 1934, Capps first reported a case of massive hemorrhage secondary to rupture of a parathyroid adenoma. Recently, we experienced a 73-year-old female presented with pharyngeal discomfort and extensive ecchymosis over the neck without history of trauma. Endoscopic investigation revealed submucosal hemorrhage in the posterior wall of the hypopharynx. CT scan and ultrasonography demonstrated the presence of a mass below the left thyroid lobe. Serum calcium level was normal and PTH level was elevated. We underwent left thyroidectomy and parathyroidectomy 2 weeks later from first visit. During the operation, hypopharyngeal mucosa was teared and it was treated with pharyngostoma formation and L-tube feeding. We report a rare case of normocalcemic parathyroid adenoma with spontaneous hemorrhage and propose the proper management period with a literature review

Keyword

Parathyroid adenoma; Cervical hematoma; Pharyngocutaneous fistula

MeSH Terms

Aged
Calcium
Ecchymosis
Female
Hematoma*
Hemorrhage
Humans
Hypopharynx
Mucous Membrane
Neck
Parathyroid Neoplasms*
Parathyroidectomy
Rupture
Tears
Thyroid Gland
Thyroidectomy
Tomography, X-Ray Computed
Ultrasonography
Calcium