CASE REPORT   

Chirurgia 2021 August;34(4):178-80

DOI: 10.23736/S0394-9508.20.05125-6

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Cervicomediastinic hematoma for spontaneous hemorrhage of adenoma of parathyroids: presentation of case and review of literature

Silvia MATARREDONA-QUILES ✉, Paula MARTÍNEZ-RUÍZ DE APODACA, Fernando GUALLART-DOMENECH, José DALMAU-GALOFRE

Department of Otolaryngology, Head and Neck Surgery, Doctor Peset University Hospital, Valencia, Spain

Spontaneous parathyroid hemorrhage is uncommon, with only 62 cases described in the literature. Bleeding parathyroid adenoma is the most frequent cause. We report a case of a 54-year-old woman that presented spontaneous abrupt dysphagia and left laterocervical mass, with history of primary hyperparathyroidism. Radiological examination showed a left lateral cervical hematoma together with a parathyroid adenoma. The evolution of the patient was observed and spontaneous reabsorption occurred, and hyperparathyroidism was solved. However, calcium and PTH levels underwent a progressive increase during the following year, and eventually hyperparathyroidism recurred. Surgical excision of parathyroid adenoma was performed and hyperparathyroidism was successfully resolved. Histological examination reported a non-malignant parathyroid adenoma. The authors provide a discussion of the etiopathogenesis, diagnosis and treatment of cervicomediastinic hematoma due to parathyroid bleeding. Additionally, as previous cases have reported “autoparathyroidectomy” after parathyroid hemorrhage, we consider conservative treatment to be the best option, whenever possible, avoiding the risks of cervical surgery.

KEY WORDS: Hematoma; Parathyroid diseases; Hyperparathyroidism, primary; Parathyroid neoplasms