Spontaneous hemorrhage of a parathyroid adenoma into the mediastinum.
OBJECTIVE
To describe the case of a previously healthy 56-year-old woman, who presented with acute, nontraumatic pain in the left side of the neck and mild dysphagia.


METHODS
We report the results of the physical examination, imaging studies, and clinical laboratory studies. In addition, we describe the patient's hospital course after surgical intervention.


RESULTS
A patient who sought medical attention because of acute, nontraumatic neck pain and dysphagia was subsequently found to have acute extracapsular hemorrhage of a parathyroid adenoma. Computed tomography and magnetic resonance imaging studies revealed a mass effect beginning in the neck and extending into the mediastinum. Surgical exploration of the neck and histopathologic evaluation confirmed the diagnosis of spontaneous rupture of a parathyroid adenoma with associated hemorrhage.


CONCLUSIONS
Extracapsular hemorrhage of a parathyroid adenoma is rare and necessitates a high index of clinical suspicion for diagnosis. This diagnosis should be considered in a patient who presents with acute anemia, hypercalcemia, and a neck mass.
Department of Internal Medicine, Marshfield Clinic, Marshfield, WI 54449, USA. huang.jingbo@marshfieldclinic.org
Jingbo
J
Huang
Athanasios
A
Soskos
Safwan M
SM
Murad
Bruce R
BR
Krawisz
Steven H
SH
Yale
Andrew C
AC
Urquhart
D000236:Adenoma / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D003680:Deglutition Disorders / Q000209:etiology; D003937:Diagnosis, Differential; D005260:Female; D006470:Hemorrhage / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008477:Mediastinal Diseases / Q000209:etiology* / Q000601:surgery; D008875:Middle Aged; D019547:Neck Pain / Q000209:etiology; D010282:Parathyroid Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D012422:Rupture, Spontaneous / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome