Spontaneous retropharyngeal hematoma of a parathyroid cyst: report of a case.
A 41-year-old woman presented with severe and sudden anterior neck swelling, pain, and dysphagia. Computed tomography (CT) scan and ultrasound of the neck showed a giant mass in the retropharyngeal space, displacing the trachea and esophagus anteriorly. Aspiration cytology was done, following which extensive cervical and chest ecchymosis occurred and her symptoms immediately improved. A repeat CT scan demonstrated that the cervical giant mass had vanished, but there was a residual mass in the left paratracheal space. Exploratory surgery of the neck revealed a parathyroid cyst with severe adhesion to the surrounding tissues. We considered that a ruptured parathyroid cyst had induced massive hemorrhage into the cervical tissues and mediastinum, but that the hemorrhage had been absorbed. Extracapsular hemorrhage from a parathyroid adenoma or cyst is rare, especially from a parathyroid cyst. In fact, to our knowledge, this represents only the third case of symptomatic spontaneous bleeding of a parathyroid cyst. Nevertheless, this entity should still be considered in the differential diagnosis of all rapidly progressing retropharyngeal masses.
Department of Thoracic Cardiovascular Surgery, Tottori Prefectural Central Hospital, 730 Ezu, Tottori 680-0901, Japan.
Iwao
I
Taniguchi
Tomoyuki
T
Maeda
Keisuke
K
Morimoto
Shigeto
S
Miyasaka
Takako
T
Suda
Takesi
T
Yamaga
D000236:Adenoma / Q000150:complications* / Q000000981:diagnostic imaging; D000328:Adult; D003560:Cysts / Q000150:complications* / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005260:Female; D006406:Hematoma / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D009333:Neck; D010282:Parathyroid Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging; D011859:Radiography; D012422:Rupture, Spontaneous