title: Syncope in a patient with spontaneous hemorrhage into a thyroid nodule.
abstract: BACKGROUND
  Spontaneous hemorrhage into a thyroid nodule occurs exceedingly rare and rarely a neck hematoma can develop. We report a case of syncope due to spontaneous hemorrhage into a thyroid nodule during anticoagulant and antithrombotic therapy.
  
  
  METHODS
  A 64-year-old man was transferred to the emergency department of our hospital because of syncope. His physical examination revealed a 7 x 5 cm hard and painless mass at the left neck region. The neck MRI confirmed a heterogeneous, hyperintense mass in the left lobe of thyroid compressing the trachea and left common carotid artery, internal jugular vein, and vagus nerve bundle. He did not require a surgery in the follow-up. As the hematoma underwent subtotal shrinkage, he remained well without syncope.
  
  
  CONCLUSIONS
  Hemorrhage into a thyroid nodule should always be considered in patients presenting with neurally mediated syncope.
authors.affiliation: > Department of Endocrinology and Metabolism Disease, Recep Tayyip Erdogan University Medical School, Rize, Turkey.
authors.forename: Sb
authors.initials: S
authors.lastname: Sahin
authors.affiliation: Department of Internal Medicine, Recep Tayyip Erdogan University Medical School, Rize, Turkey.
authors.forename: T
authors.initials: T
authors.lastname: Belice
authors.affiliation: Department of Radiology, Recep Tayyip Erdogan University Medical School, Rize, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Ogullar
authors.affiliation: Department of Internal Medicine, Recep Tayyip Erdogan University Medical School, Rize, Turkey.
authors.forename: T
authors.initials: T
authors.lastname: Ayaz
authors.affiliation: Department of Internal Medicine, Recep Tayyip Erdogan University Medical School, Rize, Turkey.
authors.forename: E
authors.initials: E
authors.lastname: Cure
keywords: Syncope; hemorrhage; thyroidnodule