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  • Title: Parathyroid adenoma presenting with spontaneous cervical and anterior mediastinal hemorrhage: A case report.
    Author: Khan S, Choe CC, Shabaik A, Bouvet M.
    Journal: Medicine (Baltimore); 2019 Feb; 98(5):e14347. PubMed ID: 30702621.
    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.
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