Spontaneous cervical haemorrhage of a parathyroid adenoma

Endocrinology, Diabetes & Metabolism Case Reports

article

Lara Ulrich¹  Graham Knee¹  Colin Todd¹ 

[1] Kingston Hospital

关键词: Adult;    Female;    White;    United Kingdom;    Parathyroid;    Endocrine-related cancer;    PTH;    Parathyroid adenoma;    Hyperparathyroidism (primary);    Haemorrhage;    Cervical pain;    Ecchymoses;    Dysphonia;    Hypercalcaemia;    PTH;    CT scan;    Ultrasound scan;    Sestamibi scan;    Calcium (serum);    Histopathology;    Surgical biopsy;    Radiology/Rheumatology;    Surgery;    Unique/unexpected symptoms or presentations of a disease;    June;    2015;   

DOI  :  10.1530/EDM-15-0034

学科分类：血液学

来源: Bioscientifica Ltd.

【 摘 要 】

Haemorrhage of a parathyroid adenoma is a rare clinical presentation. This report describes a previously fit and well 54-yearold woman who presented with acute neck swelling and pain with an overlying ecchymosis. Admission laboratory testsrevealed a raised parathyroid hormone and hypercalcaemia. A computed tomography (CT) scan showed widespread anteriorcervical haemorrhage and a lesion at the inferior pole of the left thyroid gland. A working diagnosis of spontaneoushaemorrhage from a parathyroid adenoma was made. As she was haemodynamically stable, she was treated conservativelywith a period of observation in hospital to monitor for signs of neck organ compression. Follow-up imaging with CT,ultrasound and sestamibi confirmed the likely source of haemorrhage as a parathyroid nodule with significant vascularity.The diagnosis was confirmed on histopathological analysis after elective surgical exploration of the neck 6 months after herpresentation. This revealed a benign parathyroid adenoma with evidence of acute and chronic bleeding. The patient made afull recovery with immediate normalisation of her biochemistry post-operatively. Despite developing a hoarse voice in theimmediate post-operative period, this resolved completely within 1 month. This case report provides further evidence tosupport a minimal delay for elective surgery after conservative management to reduce the risks associated with recurrentbleeding.

【 授权许可】

CC BY-NC-ND