Spontaneous extracapsular parathyroid adenoma hemorrhage: when surgery is required?

Familiari, Marco; Santo, Davide Di; Galli, Andrea; Danè, Giulia; Giordano, Leone; Mellone, Renata; Bussi, Mario

doi:10.1007/s12020-021-02876-x

Cited by 4 publications

(2 citation statements)

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“…Imaging tests, including CT scans, ultrasonography, or magnetic resonance imaging, are indispensable for diagnosing and pinpointing the location of the hematoma. The differential diagnosis should consider other conditions, such as cervical abscess, superior vena cava syndrome, cervical dissection, or subacute thyroiditis ( 5 , 12 ).…”

Section: Discussionmentioning

confidence: 99%

“…Spontaneous parathyroid hemorrhage is an exceptionally rare, yet potentially life-threatening condition due to airway compromise, often necessitating urgent surgical intervention. Clinically, it manifests with symptoms, such as cervical pain, dysphagia, dysphonia, or dyspnea, and physical examination may reveal ecchymosis in the cervical and/or thoracic regions ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Spontaneous cervical hematoma caused by giant parathyroid adenoma in an elderly patient: A case report

Matías‑García,

Mendoza‑moreno,

Díez‑Alonso

et al. 2023

Med Int

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Spontaneous cervical hematoma usually occurs as a consequence of extracapsular bleeding from a parathyroid gland, generally due to the presence of an adenoma (giant adenoma), glandular hyperplasia, cystic component, or, less frequently, due to the existence of a carcinoma. The hematoma can be confined to the cervical compartment or extend to the mediastinum, potentially causing airway compression. Despite this, the recommended management in hemodynamically stable patients consists of surveillance and hospital monitoring with delayed surgery after a few weeks. On the other hand, in those patients with airway compromise and instability, emergency surgery, consisting of cervicotomy and drainage, is mandatory. The present study describes the case of a 78-year-old patient with a medical history of high blood pressure, non-insulin-dependent diabetes mellitus, dyslipidemia, moderate aortic stenosis, chronic kidney disease and sarcoidosis under pharmacological treatment who attended the emergency department due to symptoms of neck pain, an increase in soft tissue, and dyspnea on moderate exertion with an evolution leading to respiratory failure. This was secondary to a diagnosis of spontaneous cervical hematoma that required urgent surgical intervention. The results of histopathological analysis revealed that a giant parathyroid adenoma was responsible for the bleeding. The patient had a complicated post-operative period with a prolonged admission to the intensive care unit.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%