CASE REPORTS
JOURNAL ARTICLE
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Parathyroid adenoma presenting with spontaneous cervical and anterior mediastinal hemorrhage: A case report.

Medicine (Baltimore) 2019 Februrary
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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