title: Spontaneous rupture of a parathyroid adenoma presenting as a massive cervical hemorrhage: report of a case.
abstract: We report an unusual case of spontaneous rupture of a parathyroid adenoma causing cervical hemorrhage. A 60-year-old woman presented to our hospital after the sudden development of extensive ecchymosis of her neck and upper anterior chest wall. Computed tomography (CT) scanning revealed a hematoma in the left retrotracheal space, and laboratory examinations revealed significant hypercalcemia, hypophosphatemia, and a high level of intact parathyroid hormone. Primary hyperparathyroidism was diagnosed, but it was not until the hematoma had subsided, 4 months after her initial presentation, that a parathyroid adenoma was revealed by CT. An operation was performed, and a parathyroid adenoma with hemosiderin deposition was histologically diagnosed. Although this phenomenon is unusual, all endocrine surgeons should be well aware of the possibility of its occurrence.
authors.affiliation: Second Department of Surgery, Kagawa Medical University, Kita-gun, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Kihara
authors.forename: H
authors.initials: H
authors.lastname: Yokomise
authors.forename: A
authors.initials: A
authors.lastname: Yamauchi
authors.forename: A
authors.initials: A
authors.lastname: Irie
authors.forename: K
authors.initials: K
authors.lastname: Matsusaka
authors.forename: A
authors.initials: A
authors.lastname: Miyauchi
mesh_terms: D000236:Adenoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D005260:Female; D006470:Hemorrhage / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D009333:Neck; D010280:Parathyroid Glands / Q000473:pathology; D010282:Parathyroid Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D016105:Parathyroidectomy; D012422:Rupture, Spontaneous; D014057:Tomography, X-Ray Computed